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