Tuesday, February 12, 2013

Postoperative Rehabilitation Protocol For Anterio

POSTOPERATIVE REHABILITATION PROTOCOL

FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

(PATELLAR TENDON GRAFT) (PTG)



preoperative Tests:

1. Laxity testing (KT-1000)

2. Range of motion measurements

3. Thigh picnic measurements

4. All limits-of-motion clinical testing

Post-Operative Positioning:

1. Compression dressing, ice to stifle

2. Immobilizer with genu in straight (0 degrees) extension (the struts for the

immobilizer should be bent knocked out(p) into a position of relative knee recurvation

which generally keeps a knee with a postop dressing in spacious extension).

3. tight-laced knee elevation

4. Immediate quad sets; ankle pumps encouraged

***Treat unite extraarticular and/or meniscal repair ACL/PTG as

ACL/PTG

(if in doubt contact surgeon)***

postoperative Day One:

1. No pillow under knee at any time for first six weeks. Pillows should

ceaselessly support foot/ankle while in bed.

2. out(p) of bed

3. Quad sets - 30 reps, 3-5 times daily. Five quads hard for 6 seconds.

Relax for 3 seconds. Repeat.

4. Ankle pumps every hour.

5. protect weighting bearing with crutches to tolerance

6. Dressing changes prior to hospital discharge

7. Obtain full dormant extension (0 degrees) out of immobilizer (essential)

8. Achieve 90 degrees of inflection

9.

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Protected weight bearing as tolerated (WBAT) with crutches

10. Exercises (out of immobilizer):

a. Quad sets

b. Active aided knee flexion (sitting)

c. Hamstring stretches

d. Passive extension to 0 degrees

e. Standing bedevil curls

Discharge Protocol:

1. Gait-weight bear as tolerated with crutches

2. Exercises (out-of-brace):

Flexion Exercises (4 times daily):

- Active assisted knee flexion (sitting) to > 90 degrees (as tolerated)

- Sitting/standing hip flexion

- Standing hamstring curls

Extension exercises:

- Quadriceps stretch to achieve full passive extension (frequently)

- Quad sets (10 sets of 30 daily)

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