Acl reconstruction postoperative protocol rosenberg. Early activity following pcl repair can lead to increased laxity. Rehabilitation protocol for acl reconstruction this protocol is intended to guide clinicians and patients through the postoperative course of an acl reconstruction. Approximately 200 000 acl injuries occur annually in the united states, leading to nearly. You will return to see your surgeon at the following intervals after surgery. Rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery.
Time frames for brace or crutches may be extended by dr. Posterior cruciate ligament rehabilitation protocol. Acl reconstruction rehabilitation protocol one of the most common complications following acl reconstruction is loss of motion, especially loss of extension. The most important ligament to the knees stability is the a nterior cruciate ligament acl. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making.
The goal of these videos is to help maximize your recovery following acl reconstruction surgery. A complete tear of the acl has minimal ability to heal and. Posterior cruciate ligament rehabilitation protocol it is important to understand that all time frames are approximate and that progressions should be based on individual monitoring. About the anterior cruciate ligament acl there are four main ligaments that stabilize the knee. Rehabilitation protocol for anterior cruciate ligament. If suspect an acl sprain, we strongly advise you seek professional medical advice as soon as possible. Acl rehab guidelines clinicgym exercise program phase i weeks 12 postop 23 x per week isolated acl reconstruction without meniscus repair or other ligamentous repair this protocol details general guidelines for standard acl rehab with some key exercises goals in each phase. Rehabilitation guidelines for acl reconstruction in the adult. This video should not be used as a substitute for regular physical therapy visits and guidance from your physician. Anterior cruciate ligament acl reconstruction protocol please see the important note for stretching knee extension on page 5 the intent of this protocol is to provide a general framework for acl rehabilitation.
Loss of knee extension has been shown to result in a limp, quadriceps muscle weakness, and anterior knee pain. Click here to download pdf exercises after injury to the anterior cruciate ligament acl of the knee. This protocol must be followed to prevent injury to the acl graft. The acl is located in the center of the knee along with the posterior cruciate ligament pcl. Nonoperative acl injury adopted 398, revised 704, revised 109 1 general principles. As tolerated should be understood to include with safety for the reconstructionrepair. It is imperative not to begin new exercises prior to neuromuscular readiness. If you have suffered an acute acl injury and surgery is planned, the time between injury and surgery should be used to regain knee motion, decrease swelling, and maintain muscle tone. Acl reconstruction rehabilitation protocol 4 restore normal range of motion you should attempt to achieve full range of motion as quickly as possible. Acl rehab guidelines clinicgym exercise program phase i. Acl reconstruction physiotherapy advice for patients oxford.
Do at least 20 repetitions three or four times a day until you can fully straighten your. This program involves no special equipment and the majority of the exercises can easily be. Anterior cruciate ligament acl reconstruction protocol. It is no means intended to be a substitute for ones clinical decision making regarding the progression of. Protect graft and graft fixation with use of brace and specific exercises. However, if youre struggling for ideas, ive compiled a few of my favorite exercises into a video in no particular order to get the knee going during different phases of rehab following acl reconstruction. Rehabilitation guidelines for acl reconstruction in the. Poor core control may indicate an exercise is too advanced for the patient. On the day after surgery you should start performing knee motion exercises as detailed in this protocol. Please give a copy of this acl rehabilitation protocol to your therapist.
This booklet is designed to provide you with advice and guidance on your rehabilitation after reconstruction of your anterior cruciate ligament acl. Within 23 weeks you should achieve full knee extension and 90 degrees knee flexion. Stationary cycle, swimming flutter kick only and the following exercise program are recommended. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Progressive resistance exercises 3050 repetitions, 05 pounds, 3 times per day. Rehabilitation protocol for acl reconstruction massachusetts. Neuromuscular electrical stimulation nmes combined with exercise is. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving. Note the knee is off the edge of the table 34 times a day for 1015 minutes for bending flexion. Facts transformation of the graft into a strong and durable ligament requires four months. A torn acl has serious implications for the stability and function of the knee joint, causing the knee to buckle and give way. May want to consider completing exercises with slight tibial ir to decrease stress on mcl may limit motion to the sagittal plane for 46 weeks pcl injury follow pcl protocol as it will be a slower rehab than acl typically our physicians will give us insight into the location and severity of chondromalacia grades i. Pull the heel toward the buttocks, flexing the knee.
The guide to rehabilitation of anterior cruciate ligament acl. May want to consider completing exercises with slight tibial ir to decrease stress on mcl may limit motion to the sagittal plane for 46 weeks pcl injury follow pcl protocol as it will be a slower rehab than acl typically our physicians will give us insight into the location and severity of chondromalacia grades i to iv. Quadriceps isometrics exercises, straight leg raises, and range of motion exercises should be started immediately. Recent advances in the rehabilitation of anterior cruciate. Acl rehab protocol is an outline of an anterior cruciate ligament sprain rehabilitation program. Nejm 10 randomized trial of treatment for acute acl tears 121 young adults, acute acl injury randomized into 2 groups. No active hamstring exercises electrical stimulation in full extension with quad sets and slr quad sets. It is held together by several important ligaments. Exercises should focus on lumbopelvic stabilization in all planes of motion and all transfers. It consists of initial first aid, mobility, strength, balance, fitness and agility exercises both before and after reconstructive knee surgery. Full extension is obtained by doing the following exercises. For many aspects of acl rehabilitation there are either no studies that qualify as bestevidence or the number of. Op rehabilitation protocol the following is a protocol for postoperative patients following acl reconstruction. Anterior cruciate ligament acl revision rehabilitation protocol the following is a protocol for postoperative patients following acl reconstruction.
Anterior cruciate ligament acl rehabilitation physiopedia. Anterior cruciate ligament rehabilitation preoperative. Acl repair rehab protocol articular cartilage paste graft rehab protocol. The most important of these to the knees stability is the anterior cruciate ligament acl. Physiotherapy following acl reconstruction protocol rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery. During phase 2 exercises can progress from simple muscular control to body weight exercises and then to a gym based program. You should begin the exercises prescribed for you on the first day after your surgery. This is a comprehensive program involving strength, balance, plyometric, agility, cardio and core. Therefore, this is not a protocol or a strict regime, but an overall rehabilitation guide. Anterior cruciate ligament rehabilitation preoperative phase prone hang exercise lie face down on the table and allow the legs to sag off the table into full extension. The sports physical therapy service is an integral part of the sports medicine center and the department of. Rehabilitation guidelines for acl reconstruction in the adult athlete skeletally mature anterior cruciate ligament acl injuries affect men and women across a wide age range and at all levels of athletics.
No resisted leg extension machines isotonic or isokinetic at any point in the rehab process. Locked in full extension for walking and sleeping for first week may allow 90 degrees flexion after first week given. Jul 08, 2019 acl rehab protocol is an outline of an anterior cruciate ligament sprain rehabilitation program. Intensive research into the biomechanics of the injured and the operated knee have led to a movement away from the techniques of the early 1980s characterized by post operative casting, delayed weight bearing and limitation of rom, to the current early rehabilitation program with immediate training of rom and weight. Anterior cruciate ligament patellar tendon autograft rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an anterior cruciate ligament reconstruction with a bonepatellar tendonbone autograft. Physiotherapy acl protocol rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery. Welcome to our acl reconstruction rehabilitation video series. The role of the anterior cruciate ligament acl is to prevent forward movement and. Acl reconstruction protocol south shore orthopedics. It contains detailed exercises appropriate for the different phases of rehabilitation. The goal of these videos is to maximize your recovery following acl reconstruction surgery. The acl attaches from the front part of the tibia to the back part of the femur.
Knee exercises for additional exercises and descriptions. Acl allograft reconstruction protocol the intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone an acl allograft reconstruction. All times and exercises are to serve as guidelines. Lie on your back with a rolled up towel under your heel or sit in a chair with the heel on a. Acl reconstruction rehab exercises mickhughesphysio. The knee is a simple hinge joint at the connection point between the femur and tibia bones. Guide to acl reconstruction rehabilitation welcome to our acl reconstruction rehabilitation video series. Straighten the leg by sliding the heel downward and hold for 5 seconds.
The guide to rehabilitation of anterior cruciate ligament acl reconstruction. Physical therapy may be necessary prior to surgery. Hamstring acl reconstruction rehabilitation protocol anterior. The anterior cruciate ligament acl is one of four major. Moon acl rehabilitation guidelines general information. If any of these exercises seem to aggravate the knee swelling, pain or tenderness, then that specific exercise which causes the difficulty should be postponed until you have discussed the effects of the exercise with us 9524567122.
Progression through the protocol should be based upon criteria as opposed to dates listed and will vary depending on each individual patient. Brace will be worn for 10 weeks to protect graft, 0 to 90 degrees. Find pdfs of our most common rehabilitation protocols. The exercises will help to strengthen the muscles around the knee and help you to regain full range of movement. Acl rehabilitation has undergone considerable changes over the past decade. It is usually helpful to take your pain medication prior to the removal of the drain and start of the rehabilitation. The following is a general guideline for progression of. Acl reconstruction rehabilitation protocol 6 3 heel slides are used to gain final degrees of flexion.
The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving preinjury level of activity. Repair postsurgical rehabilitation protocol postop days 1 14 dressing. Anatomy and biomechanics the knee is a hinge joint connecting the femur and tibia bones. Acl hamstring tendon autograft reconstruction protocol the intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone an acl hamstring tendon autograft reconstruction. Anterior cruciate ligament acl and meniscus repair. Time frames mentioned in this booklet are based on. The exercises will help to strengthen the muscles around the. Sports medicine physical therapy rehabilitation protocols. Anterior cruciate ligament hamstring rehabilitation protocol. If acl reconstruction with meniscal repair, then range of motion limited from 0 to 90 degrees, 20 pounds partial weight bearing on operative leg with crutches and brace locked for period of time determined by dr. The guide to rehabilitation of anterior cruciate ligament. Nhs trust acl reconstruction physiotherapy advice for. Acl reconstruction rehabilitation protocol sports medicine north.
Hamstring acl reconstruction rehabilitation protocol anterior cruciate ligament hamstring rehabilitation protocol based on the fowler kennedy sports medicine clinic acl rehab guidelines preoperative rehabilitation prior rehabilitation is essential for improved outcomes following anterior cruciate ligament acl reconstruction surgery. Add wall slides see figure 3 and hand assisted heel drags to increase your range of motion. Acl hamstring tendon autograft reconstruction protocol. If certain muscle groups remain weak, this leads to. Nhs trust acl reconstruction physiotherapy advice for patients. In the acute period after acl reconstruction the knee needs some time to recover from the acute trauma of surgery. The role of the anterior cruciate ligament acl is to prevent forward movement and rotation of the tibia shin bone on the femur thigh bone. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. Therapy and a devoted home exercise program are essential in order to achieve a good outcome for your knee. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes.
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