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ACL PATELLAR TENDON AUTOGRAFT RECONSTRUCTION
REHABILITATION PROTOCOL
|
WEIGHT
BEARING |
BRACE |
ROM |
THERAPEUTIC
EXERCISES |
PHASE I
0 - 4 weeks |
As tolerated with
crutches* |
0 -1 week: locked in
full extension for
amulation and sleeping
1 -4 weeks: unlocked
for ambulation, remove
for sleeping** |
As tolerated |
Heel slides, quard/hamstring sets,
patellar mobs, gastroc/soleus
stretch***, SLR with brace in full
extension until quad strength
prevents extension lag |
PHASE II
4 - 6 weeks |
Gradually
discontinue
crutch use |
Discontinue use
when patient has full
extension and no
extension lag |
Maintain full
extension and
progressive
flexion |
Progress to weight bearing
gastroc/soleus stretch, begin toe
raises, closed chain extension,
balance exercises, hamstring
curls, and stationary bike |
PHASE III
6 weeks -
4 months |
Full, without use
of crutches and
with a normalized
gait pattern |
None |
Gain full and pain-free |
Advance closed chain
strengthening, progress
proprioception activities, begin
Stairmaster/Nordic Trac and
running straight ahead at 12 weeks |
PHASE IV
4 - 6 months |
Full |
None |
Full and
pain-free |
Progress flexibility/strengthening,
progression of function: forward/
backward running, cutting, grapevine,
etc., initiate plyometric program and
sport-specific drills |
PHASE V
6 months
and beyond |
Full |
None |
Full and
pain-free |
Gradual return to sports participation,
maintenance program for strength
and endurance. |
*Modified with concomitantly performed meniscus repair/transplantation or articular cartilage procedure
**Brace may be removed for sleeping after first post-operative visit (day 7-10)
***This exercise is to be completed in a non-weight bearing position
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