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ACL Reconstruction with Patellar Tendon Allograft or Autograft

PHASE 1: 0-4 WEEKS

  • WBAT with crutches and brace locked in full extension x 1 week
    • Goal: WBAT w/o assist by 1 week
  • WBAT with crutches and brace unlocked at 1 week post post-op
    • May remove brace for sleeping at 1 week post-op
  • ROM: progress from passive to active to resisted ROM as tolerated
    • Extension board and prone hangs with weight up to 10 lbs
    • Goal: Full extension by 2 weeks post-op, 120° by 4 weeks post-op
  • Strengthening: quad sets, heel slides, 4 way SLR with knee locked in extension. (NMES as needed for Quad re-education).
  • Daily Patellar Mobilization

PHASE 2: 4-10 WEEKS

  • ROM: progress to full ROM
  • Strengthening: closed chain exercises, calf stretches, toe raises, hamstring curls, balance exercises, core program, slide board
  • May use stationary bike or outdoor bike for ROM, strengthening, cardio
  • Discontinue brace with full extension and no extension lag

PHASE 3: 10 WEEKS – 4 MONTHS

  • Continue strengthening exercises: pulley weights, theraband, proprioception
  • May begin Stairmaster/Nordic Trac and in-line running (no cutting/pivoting) at 3 months post-op in custom ACL brace

PHASE 4: 4 MONTHS- 6 MONTHS

  • Strengthening: begin plyometrics and increase as tolerated
  • May begin agility training (cutting, grapevine, etc) and sport-specific drills beginning in custom ACL brace

PHASE 5: 6 MONTHS+

  • Gradual return to sports participation in custom ACL brace
  • Maintenance program for strength and endurance