This protocol is intended to be a general guideline. The physician staff may advance, delay, or alter this protocol based on individual patient status. If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form provided to the patient or therapist.
The therapist should check with physician staff re: co-morbidities that may affect protocol progression, such as meniscal tears, chondral defects, or bone bruise.
Guidelines for Pre-Op Physical Therapy
- Patient will receive instruction from Dr. Chams or one of his physician extenders on post-operative expectations, post-op Day One exercises, and use of crutches or another assistive device for NWB ambulation. If deemed necessary at that time, the patient may be referred for one pre-op PT visit to receive gait training, review post-op exercises, and discuss post-op expectations.
Guidelines for Post-Op Physical Therapy Visits
- Therapy begins on Day One post-op in the outpatient clinic.
- Patient is typically seen in clinic 1x/week for the first 6 weeks. May be increased if flexion ROM is poor, or decreased if patient is doing well with independent HEP.
- Then increase to 2x/week until about 12 weeks post-op, at which time patient may be seen 1x/week or every other week as appropriate based on patient status and HEP compliance until functional goals are achieved.
Guidelines for Wound Care
- Original steri-strips should be left in place until stitch removal. They can be reinforced with more steri-strips if needed.
- On Day One post-op, remove bulky post-op cotton and gauze dressings. Place 2×2 gauze pads and occlusive dressing over wound sites. Change dressings as needed and do not allow wounds to become wet.
- Instruct patient to wrap knee in “press and seal” plastic wrap for showering until 3-5 days after stitches are removed (make sure wounds are fully healed before being exposed to water).
Guidelines for Ambulation and Hinged Knee Brace
- Unless otherwise specified, patient will be NWB for 6-8 weeks post-op.
- Hinged (TROM) knee brace will be issued at surgical center. Brace should be adjusted for correct fit by therapist at first PT visit post-op.
- Brace to be worn and locked at 0 degrees extension with all ADL’s for TTWB first 6 weeks. Brace may removed for bathing and exercises.
- At Week 6, allow FWB with TROM brace locked in extension IF patient has good quad control in WB’ing and with MD clearance. Delay until Week 8 if needed.