Phase I (Weeks 0-6)
- Weightbearing: Non-weightbearing
- Bracing:
- Hinged knee brace locked in extension (week 1) – remove for CPM and rehab with PT
- Weeks 2-6: Gradually open brace in 20° increments as quad control is obtained
- D/C brace when patient can perform straight leg raise without an extension lag
- Range of Motion – Continuous Passive Motion (CPM) Machine for 6-8 hours per day for 6-8 weeks
- Set CPM to 1 cycle per minute – starting at 40°of flexion
- Advance 10° per day until full flexion is achieved (should be at 100° by week 6)
- PROM/AAROM and stretching under guidance of PT
- Therapeutic Exercises
- Patellar mobilization
- Quad/Hamstring/Adductor/Gluteal sets – Straight leg raises/Ankle pumps
- Stationary bike for ROM
Phase II (Weeks 6-8)
- Weightbearing: Advance to full weightbearing as tolerated — discontinue crutch use
- Range of Motion – Advance to full/painless ROM (patient should obtain 130° of flexion)
- Therapeutic Exercises
- Closed chain exercises – wall sits, shuttle, mini-squats, toe raises
- Gait training
- Patellar mobilization
- Begin unilateral stance activities
Phase III (Weeks 8-12)
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- Advance closed chain strengthening exercises, proprioception activities
- Sport-specific rehabilitation
- Therapeutic Exercises
- Range of Motion – Full/Painless ROM
- Weightbearing: Full weightbearing
- Gradual return to athletic activity as tolerated
- Jogging — 3 months
- Higher impact activities – 4-6 months
- Maintenance program for strength and endurance