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Pre-op phase

• Quad sets, straight leg raises, crutch training

Perioperative phase

• Immediate post-op: CPM 0-45 degrees)
• Second post-op day:
• In hinged knee brace quad sets and ankle ROM’s
• Straight leg raises assisted or eccentric slow to avoid hemarthrosis
• Electrical stimulation as needed
• Weightbearing as tolerate with crutches and brace locked in extension)

Post-operative Days 5-7

• 20-25 straight leg raises in brace; no more than 40-50 three times a day
• Passively flexing 0-45 degrees
• Hamstring setting and stretching
• Hip exercises in splint abduction, extension and adduction

Weeks 1-3

• Obtain 45 degrees flexion in brace
• Active hamstrings contraction and passive knee extensions

Weeks 3-12

• Assisted ROM’s (patient should get to 40 degrees flexion by 6 weeks)
• Straight leg raising, terminal extension, hamstring stretching, quad setting
• Wean brace at 4-6 weeks and wean off crutches at 6-8 weeks

Late phase (12 weeks) Indefinite

• Weights (low weights/high reps), bicycling (keep seat high) and functional activities
• Jogging or running is the last thing allowed
• Patient must be able to run without a limp; if limp occurs, stop running and continue weights until swelling subsides
• Progressive running program
• 1^st day: ¼ mile/run 100 yards/walk 100 yards
• routine continued over time until patient can run ¼ mile
• 2^nd week: ½ mile run (slow) three times per week
• 3^rd week: ¾ mile run (slow) three times per week
• 4^th week: 1 mile run (slow) three times per week
• 5^th week: begin sprints 40 yard dash (1/2 speed) then ¾ speed and progress to full speed
• 6^th week: agility drills