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