This protocol is intended to be a general outline only. The physician reserves the right to either advance or delay this protocol as deemed necessary. If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form given to the patient on the day of surgery.
Weeks 0 – 6 Post-Op
Patient seen 1-2x/week as needed.
Precautions: Patient is NWB during this period.
Goals: Decrease pain, allow healing, PROM to 110 degrees
NWB’ing with T-ROM brace locked in extension
T-ROM can be removed for ROM / physical therapy sessions
CPM to begin Post-Op Day One: 0-45 degrees for 2 hrs BID or TID.
CPM can be increased 5-10 degrees per day as tolerated by patient.
Open-chain quad exercises (SLR’s, quad sets, etc.)
Open-chain hip strengthening
If warranted, provide patient with home e-stim unit to be used while doing quad sets.
Patellar joint mobs, hamstring stretching, open-chain ankle strengthening
Weeks 6 – 8: Patient seen 2-3x/week
Goals: Full ROM, progress to PWB (50%)
Weeks 8 – 12: Patient seen 2-3x/week
Goals by Week 12: FWB, full pain free ROM
Continue above exercises
Progress to full pain-free ROM
Begin closed-chain strengthening activities (calf raises, mini-squats, lateral lunges, etc.), starting at <30 degrees flexion and gradually increasing depth with good form
Focus on core strength and knee joint control in closed-chain positions
Begin single leg stance balance activities
Discontinue T-ROM when quad control is sufficient for stable closed-chain control of knee extension
Begin Proprio Machine training
Weeks 12 – 16: Patient seen 1-2x/week
Goals: Progress strength, normalize gait.
Continue appropriate previous exercises
Achieve normal gait pattern
Full pain free ROM
Advance both open and closed-chain strength exercises as tolerated.
Progress to full biking, elliptical machine
Weeks 16 and beyond: Patient seen as needed
Goals: Return to sport and full function.
Begin lateral plyo shuffles
Perform Proprio Test
At 20 weeks: begin jogging and then progress to running drills if patient has good control and endurance with above exercises
Progress to bilateral and unilateral hopping drills
Begin sport-specific drills
Return to Sport Guidelines
Running: Begin independent jogging at 4 months post-op, increasing running time by 5-minute increments to tolerance. Begin more strenuous running programs incorporating various terrain and inclines at 6 months post-op.
Revised 5.18.13 – TJB