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AFTER KNEE LIGAMENT RECONSTRUCTION OR REPAIR

This rehabilitation program is not fixed in stone and may be adapted depending on intra-operative findings, occurrences and results.

Day one post-op:

  1. Application of ice packs 20-30mins every 4 hrs. Always protect skin. Continue ice pack use regularly for 3 days and after exercising thereafter.
  2. Gentle knee flexion to 25 degrees.
  3. Passive knee extension over side of bed using good leg to lift operative lower leg for anterior cructite reconstruction with active flexion.
  4. Passive flexion with active extension as above for posterior cruciate reconstruction.
  5. Up with crutches flat foot partial weight bearing with knee brace set to allow Zero to 90 degrees flexion.
  6. Practice stair walking with double crutches then discharge.

NO WEIGHTS OR RESISTED EXERCISING FOR THE FIRST 4 WEEKS

Day 2 to 14 post-op:

  1. Continue exercises as shown prior to discharge.
  2. Concentrate on gaining full extension and flexion to 90 degrees.
  3. Standing hamstring curls with flexion of knee in anterior cruciate cases using gravity to aid extension.
  4. Sitting leg extension exercises for posterior cruciate cases using gravity to flex the knee.
  5. Out-patient physiotherapy to begin.
  6. Increase flexion and gain full extension with passive stretching and active hamstring ( in ACL recon) and active quadriceps (in PCL recon) exercises.
  7. Begin static cycling as range of motion allows.
  8. Aim for 90 degrees of flexion at the end of 2 weeks.

Day 14 to 28 post-op

  1. Progress as above with the aim of full range of motion by 6 weeks.
  2. Can remove brace for cycling and passive stretching with the physiotherapist.

Day 28 to 6 weeks post-op

  1. At 4 weeks may begin driving.
  2. Add light weights or resistance during controlled exercising.

Six to Eight weeks post-op

  1. Intensive daily physiotherapy for 2 weeks is best.!
  2. Remove brace and crutches with progression to full weight bearing.
  3. Proprioceptive (Balance and joint position sense) rehabilitation.
  4. Treadmill fast walking progressing to gentle jogging.
  5. Progressive strengthening with increased weights or resistance. Controlled exercises only.

Eight to twelve weeks post-op

  1. Continue weight training.
  2. Begin agility and eccentric exercises, e.g. figure of eight jogging

Three months post-op

  1. Can commence open chain exercises.
  2. Return to sport if quadriceps and hamstring strength > 85% of normal. Should be able to perform single legged hop almost as easily as normal side.

Six months post-op

  1. Contact sports may begin

FOLLOW-UP ROUTINE

  1. Seen in rooms 10 days following surgery for wound check and removal of dressings.
  2. Seen again at 6 weeks to confirm full range of motion.
  3. Seen then at 6 weekly intervals till 6 months.
  4. Longer follow-up at the 9 month mark and finally at 1 year.
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