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Knee Arthroscopy
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ACL Reconstruction Rehab Protocol
Stage I
0-2 weeks
- Patellar
mobilizations (emphasize superior/inferior glides)
- Motion
control brace 0-90
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Quad
sets/straight-leg raises all planes (emphasize straight-leg raise
without extension lag)
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Prone/standing
hamstring curls
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Passive
extension (emphasize full extension)
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Prone
hangs
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Pillow
under heel
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Passive,
active, and active-assisted range-of-motion knee flexion
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Wall
slides
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Sitting
slides
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Prone
towel pulls
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Edema
control—compression pump
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Electrical
stimulation for muscle re-education if poor quadriceps set
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Cryotherapy
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Partial
weight-bearing 50-75% with crutches or weight-bearing to tolerance
without crutches if motion control brace locked in full extension
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Sleep
in brace locked in extension
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Goals:
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Full
knee-extension range of motion
-
90
knee-flexion range of motion
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Good
quad set
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Emphasize
normal gait pattern
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Stage II
2-4
weeks
- Motion
control brace full range of motion
- Progress
range of motion to 120 by 4 weeks
- Progress
straight-leg raises and prone/standing hamstring curls with weights
- Bike
for range of motion, begin low-resistance program when range of
motion adequate
- Stool
scoots
- Full
weight-bearing with crutches, discontinue crutches when ambulating
without limp
- Begin
double-leg biomechanical ankle platform system, progress to
single-leg
- Begin
double-leg press with light weight/high repetitions
- Wall
sits at 45-degree angle with tibia vertical; progress time
- Lateral
step-ups (4 in.) when able to perform single-leg quarter squat
- Hip
machine and hamstring machine when able to perform straight-leg
raises with 10 lbs.
- Treadmill
(forward and backward) with emphasis on normal gait
- Knee
extension 90-60 degrees (submaximal) with manual resistance by
therapist
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- Range
of motion 0-120 degrees
- Full
weight-bearing without crutches, no limp
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4-6
weeks
- Progress
to full range of motion by 6 weeks
- Begin
Kin-Com hamstring progression (isotonic/isokinetic)
- Begin
Kin-Com quad work 90-40 isotonics with antishear pad
- Stairmaster
(forward and backward)
- Progress
closed-chain exercises
- At
6 weeks, begin Kin-Com quad work 90-40 isokinetics (start with
higher speed and work endurance)
- Aquatic
exercises
8-10
weeks
- Progress
above exercises
- Slow-form
running with sport-cord (forward and backward)
- Isokinetic
quad work at different speeds (60, 90, 120)
- Begin
lunges
- At
10 weeks, begin Fitter, slide board
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