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ACL重建术后康复程序
Preoperative
?
?
Reduce swelling
Regain full extension unless restricted by bucket handle meniscal tear
Increase flexion to maximum that is comfortable
Regain adequate Quadriceps Hamstring strength by closed chain exercises
No pivoting sport
?
?
Postoperative
Discharge- Same day in the vast majority of patients
Pain control is achieved by using infiltration of local anaesthetic in to the joint and wound plus use of a nerve block
Discharge from Hospital goals
Mobilising safely with crutches including doing stairs
Passive full extension and reasonable flexion (60-90 degrees)
Outpatient physiotherapy appointment organised
Goals for 0-2 weeks
Mobilise with the aid of crutches including indoors
Reduce bandage after 24-48 hours
Pain relief
Reduce swelling- Icing 4-6 times daily 15 minutes each time
Regain extension- heel raise and extension stretch, quadriceps bracing exercise
Regain flexion beyond 90 degrees
Mobilise patella (Patella tendon graft) and no active hamstring curls (Hamstring graft)
Goals for 2-6 weeks
Note: The graft does not heal in the tunnels for at least 6-8 weeks
Wean off crutches
Regain symmetrical hyper extension- heel raise, prone hangs (compare heel height)
Regain full flexion by heel slide using a towel (compare heel-buttock distance)
Mini squats. Bridging exercises
Proprioceptive exercises and improve joint position sense
Closed chain exercises- Exercise bike
No driving for 2-3 weeks for left knee and 4-6 weeks for right knee
6 weeks to 3 months
Closed chain exercises and straight line activities only
Gait training, core strength and balance training
Improve quadriceps and hamstring strength- exercise bike, cross trainer, Lunges, single leg dips
Low resistance and low weights but more repetition
Brisk walking, Swimming
3- 6 months
More intensive strength training
Open chain exercises allowed
Start running on a treadmill
Regain atleast 80% quadriceps and hamstring strength compared to opposite leg Progress to shuttle runs, side stepping, diagona
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