POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION REHABILITATION
- – Patients are touch-down weight bearing with crutches for 4 weeks post-operatively.
- – Patients will use a hinged neoprene brace for 8 weeks post-op. It will be locked in full extension for 4 weeks and then progressed to 0-30 at 4 weeks and 15 degrees a week until 8 weeks
- – Early emphasis on achieving full passive terminal extension equal to the opposite side. *No resisted knee flexion exercises for 8 weeks post-op. Passive flexion okay.
- – Regular manual care of the patella, patella tendon, and portals should be performed to prevent fibrosis
- – All times are approximate with actual progression based upon clinical presentation.
- – Gait training, pain and edema control, and muscle stimulation as needed for quadriceps recruitment.
- – Ankle pumps, quad sets, and leg raises into flexion and abduction only.
- – Well-leg stationary bike and UBE for cardiovascular. Upper body weight machines and trunk exercises.
- – Passive flexion and extension stretching.
- – Prone hip extension exercises performed in full knee extension only after 2 weeks.
- – Submaximal quad and gluteal isometrics.
- – Standing calf and hip exercises
- – Balance and proprioception exercises
- – Swimming and pool workouts as soon as incisions are well-healed.
- – Introduce mild isometric resisted knee extension within range of motion restrictions.
- – Short range squats/knee bends within range of motion restrictions.
- – Gradually increase the depth of knee bends, step exercises and proprioception exercises
- – Introduce hamstring curls against gravity without resistance after 7 weeks. Focus on eccentrics.
- – Continue to increase the intensity and resistance of other exercises.
- – Passive range of motion should be near normal
- – Wean off the use of the brace for activities of daily living.
- – Begin hamstring flexion exercises against light resistance. Increase as tolerated.
- – Cautiously add lateral training exercises (i.e. lateral stepping, lateral step ups).
- – Goals are to increase strength, power and cardiovascular conditioning.
- – Sport-specific exercises and training program.
- – Maximal eccentric focused strengthening program.
- – Begin light running program as able to demonstrate good strength and mechanics.
- – Goals are to develop maximal strength, power and advance to sporting activities.
- – Resisted closed-chain rehabilitation through multiple ranges.
- – Running program, balance drills and agility program.
- – Initiate plyometric training as able to demonstrate adequate strength and proper mechanics