Combined Anterior Cruciate Ligament (ACL) and Medial Collateral Ligament (MCL) Reconstruction
Phase I (Weeks 0-4)
- Weightbearing: Touch-down weightbearing
- Hinged Knee Brace: Locked in full extension for ambulation and sleeping
- Range of Motion – PROM 0-30⁰
- Therapeutic ExercisesQuadriceps Strengthening/ Straight-Leg Raise with brace in full extension until quad strength prevents extension lagPatellar mobilizationNon-weightbearing stretch of the Gastroc/Soleus
- Quadriceps Strengthening/ Straight-Leg Raise with brace in full extension until quad strength prevents extension lag
- Patellar mobilization
- Non-weightbearing stretch of the Gastroc/Soleus
Phase II (Weeks 4-6)
- Weightbearing: Advance to WBAT using crutches for balance
- Hinged Knee Brace: Open between 0 and 30⁰
- Range of Motion – Maintain full knee extension– work on progressive knee flexion (Goal: 0-60⁰ by week 6)
- Therapeutic ExercisesContinue with phase I exercises
- Continue with phase I exercises
Phase III (Weeks 6-8)
- Weightbearing: Full weightbearing
- Hinged Knee Brace: Open between 0 and 60⁰
- Range of Motion – PROM/AAROM/AROM – Progress to full ROM
- Therapeutic ExercisesContinue with quadriceps strengtheningStart open chain calf strengthening with theraband
- Continue with quadriceps strengthening
- Start open chain calf strengthening with theraband
Phase IV (Weeks 8-12)
- Weightbearing: Full weightbearing
- Hinged Knee Brace: Unlocked
- Range of Motion – Full ROM
- Therapeutic ExercisesHalf squats/Step downsProprioception activitiesClosed chain strengtheningStart stationary bike
- Half squats/Step downs
- Proprioception activities
- Closed chain strengthening
- Start stationary bike
Phase V (Months 3-9)
- Advance closed chain strengthening and proprioception activities
- Start elliptical/jogging at 6 months
- Return to athletic activity as tolerated at 9 months post-op