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Goals

• manage inflammation (cold therapy, NSAID’s, etc.)
• Controlled gains in range of motion
• Early maintenance of strength
• Immediate weightbearing in full extension
• Brace-extension lock brace (ELS)

Phase 1 (0-1 week)

• ROM’s (0-90 degrees non-weightbearing, patellar glides)
• Weightbearing in full extension with brace locked
• Controlled quadriceps strengthening, straight leg raises, quad sets, hip extension and flexion, calf raises
• Keep brace locked in extension

Phase 2 (1-4 weeks)

• Achieve 0-90 degrees of motion; continue patellar glides
• Weightbearing as tolerated with brace locked
• Continue strengthening as in phase 1

Phase 3 (4-6 weeks)

• Advance to normal range of motions
• No flexion loading beyond 90 degrees
• Strengthening
• Add mini-squats, closed chain exercises to quadriceps program, start hamstring curls, continue hip/calf strengthening
• Begin normal gait training (first unlock brace, then wean from brace)

Phase 4 (6 weeks)

• Achieve normal range of motions and continue strengthening as in phase 3
• Continue to avoid flexion loading beyond 90 degrees
• Weightbearing as tolerated without brace

Phase 5 (> 6 weeks)

• Home program

Phase 6 (4 months)

• Resume athletic activity

Phase 7 (6 months)

* Allow hyperflexion and squatting at this time