POST-OP DAYS 1 —14
- Dressing:
- POD 1: Debulk dressing, TED Hose in place
- POD 2: Change dressing, keep wound covered, continue TED Hose
- POD 7-10: Sutures out, D/C TED Hose when effusion resolved
- Brace x 8 weeks — Locked in extension for ambulation
- Crutches — Partial weight bearing (PWB) in brace (no more than 50% of body weight)
- Patellar mobilization (teach patient)
- Calf pumping
- AAROM, AROM 0-90 degrees
- Passive extension with heel on bolster or prone hangs
- Electrical stimulation in full extension with quad sets and SLR
- Quad sets, Co-contractions quads/hams
- Straight leg raise (SLR) x 3 on mat in brace — No ADD
- Short arc quads
- No stationary bike x 6 weeks
- Ice pack with knee in full extension after exercise
GOALS
- Pain/effusion control
- Good quad control
Weeks 2 - 4
- Brace x 8 weeks — Open to 0-45 degrees
- Crutches — PWB in brace
- Continue appropriate previous exercises
- Scar massage when incision healed
- AAROM, AROM 0-90 degrees only
- Total Gym for ROM (level 1-3)
- Passive flexion to 90 degrees (push up with opposite leg)
- SLR x 3 on mat, no brace if good quad control — No ADD
- Double leg heel raises
- No stationary bike x 6 weeks
- Stretches — Hamstring, Hip Flexors, ITB
GOALS
- ROM 0-90 degrees
- No extensor lag
WEEKS 4 - 6
- Brace x 8 weeks — Open to 0-90 degrees
- Crutches — PWB in brace
- Continue appropriate previous exercises
- AAROM, AROM 0-120 degrees
- Standing SLR x 3 with light Theraband bilaterally
- May begin Hip ADD with Theraband if good LE control in full extension
- Total Gym (level 3-5)— Mini squats 0-45 degrees
- Passive flexion to 90 degrees (push up with opposite leg)
- Leg press 0-45 degrees with resistance up to V4 body weight
- Hamstring curls 0-45 degrees — Carpet drags or rolling stool (closed chain)
- No stationary bike x 6 weeks
GOALS
- ROM 0-120 degrees
- No effusion
WEEKS 6 - 8
- Brace — Open to full range
- Crutches — Weight bearing as toterated(WBAT), D/C crutch when gait is normal
- Continue appropriate previous exercises
- PROM, AAROM, AROM to regain full motion
- Standing SLR x 4 with light Theraband bilaterally
- Wall squats 0-45 degrees
- Leg press 0-60 degrees with resistance up to 1/2 body weight
- Hamstring curls through full range — Carpet drags or rolling stool
- Forward, lateral and retro step downs in parallel bars
- No knee flexion past 45 degrees (small step)
- Proprioceptive training
- Single leg standing in parallel bars
- Double leg BAPS for weight shift
- Single leg heel raises
- Treadmill — Forwards and backwards walking
- Stationary !Ace — Progressive resistance and time
- Elliptical trainer
GOAL
- Full ROM
WEEKS 8 - 12
- D/C Brace
- Continue appropriate previous exercises with progressive resistance
- Leg press 0-90 degrees with resistance as tolerated
- Hamstring curls on weight machine
- Knee eqnsion weight machine
- Forward, lateral and retro step downs (medium to large step)
- Proprioceptive training — Single leg BAPS, ball toss and body blade, Grid exercises
- Treadmill — Walking progression program
- Stairmaster — Small steps
- Pool therapy
GOAL
- Walk 2 miles at 15 min/mile pace
MONTHS 3 - 4
- Continue appropriate previous exercises
- Fitter
- Slide board
- Functional activities — Figure 8s, gentle loops, large zigzags
- Treadmill — Running progression program
- Pool therapy — Swimming laps
- Quad stretches
GOAL
- Run 2 miles at easy pace
MONTHS 4 - 6
- Continue appropriate previous exercises
- Agility drills / Plyometrics
- Sit-up progression
- Running progression to track
- Transition to home / gym program
GOAL
- Return to all activities
*NO CONTACT SPORTS UNTIL 6 MONTHS POST-OP*
KNEE POST-OP PHASE I
Perform exercises below frequently: 30 reps, 3 — 5x a day
Quad Isometrics
Heel Slides
Active Assisted Motion
Ice Position 15 minutes 2-3 x per day