Post-Operative Rehabilitation Guidelines for ACL Reconstruction with Meniscal Repair (All Inside)

Weeks 0-1: • TDWB, Brace locked at 0 degrees for ambulation and sleeping • ROM: 0-90º with emphasis on full extension • Patella mobilization • SLR supine with brace locked at 0 degrees, Quad Sets • Ankle Pumps • Short crank (90mm) ergometry

Weeks 1-6: • Begin WBAT. Unlock Brace for Weight Bearing • No weight bearing past 90° for ACL with meniscal repair • D/C crutches when gait is non-antalgic (two weeks with meniscal repair) • ROM: 0-125 degrees (Maintain full extension) • Active knee extension to 40 degrees • Standard (170mm) ergometry (when knee ROM > 115 degrees) • Leg Press (80-0 degree arc) • Mini Squats / Weight Shifts • Proprioception training • Initiate Step Up program • Avoid Tibial Rotation until 6 weeks

Weeks 6-14: • D/C Brace and wean from crutches • Progressive Squat program • Initiate Step Down program • Leg Press, Lunges • Isotonic Knee Extensions (90-40 degrees, closed chain preferred) • Agility exercises (sport cord) • Versaclimber/Nordic Track • Retrograde treadmill ambulation

Weeks 14-22: • Begin forward running (treadmill) program when 8” step down satisfactory • Continue Strengthening & Flexibility program • Advance Sports-Specific Agility Drills • Start Plyometric program > 22 weeks: • Advance Plyometric program, Return to Sport (MD Directed) • **May require Functional Sports Assessment (FSA) 5-6 months post op for clearance to return to sport

Signature: ______________________________________________ Date: ___________ reconstruction