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:
- Application of ice packs 20-30mins every 4 hrs. Always protect skin. Continue ice pack use regularly for 3 days and after exercising thereafter.
- Gentle knee flexion to 25 degrees.
- Passive knee extension over side of bed using good leg to lift operative lower leg for anterior cructite reconstruction with active flexion.
- Passive flexion with active extension as above for posterior cruciate reconstruction.
- Up with crutches flat foot partial weight bearing with knee brace set to allow Zero to 90 degrees flexion.
- Practice stair walking with double crutches then discharge.
NO WEIGHTS OR RESISTED EXERCISING FOR THE FIRST 4 WEEKS
Day 2 to 14 post-op:
- Continue exercises as shown prior to discharge.
- Concentrate on gaining full extension and flexion to 90 degrees.
- Standing hamstring curls with flexion of knee in anterior cruciate cases using gravity to aid extension.
- Sitting leg extension exercises for posterior cruciate cases using gravity to flex the knee.
- Out-patient physiotherapy to begin.
- Increase flexion and gain full extension with passive stretching and active hamstring ( in ACL recon) and active quadriceps (in PCL recon) exercises.
- Begin static cycling as range of motion allows.
- Aim for 90 degrees of flexion at the end of 2 weeks.
Day 14 to 28 post-op
- Progress as above with the aim of full range of motion by 6 weeks.
- Can remove brace for cycling and passive stretching with the physiotherapist.
Day 28 to 6 weeks post-op
- At 4 weeks may begin driving.
- Add light weights or resistance during controlled exercising.
Six to Eight weeks post-op
- Intensive daily physiotherapy for 2 weeks is best.!
- Remove brace and crutches with progression to full weight bearing.
- Proprioceptive (Balance and joint position sense) rehabilitation.
- Treadmill fast walking progressing to gentle jogging.
- Progressive strengthening with increased weights or resistance. Controlled exercises only.
Eight to twelve weeks post-op
- Continue weight training.
- Begin agility and eccentric exercises, e.g. figure of eight jogging
Three months post-op
- Can commence open chain exercises.
- 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
- Contact sports may begin
- Seen in rooms 10 days following surgery for wound check and removal of dressings.
- Seen again at 6 weeks to confirm full range of motion.
- Seen then at 6 weekly intervals till 6 months.
- Longer follow-up at the 9 month mark and finally at 1 year.