Transcription of Knee ACL Reconstruction Post-Operative Guidelines
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Knee ACL Reconstruction Post-Operative Guidelines
Copyright 2019-2020 by Hospital for Special Surgery. All rights reserved. Page 1 of 22 KNEE ANTERIOR CRUCIATE LIGAMENT (ACL) Reconstruction Post-Operative Guidelines The following anterior cruciate ligament Reconstruction (ACLR) Guidelines were developed by the HSS Rehabilitation. Progression is both criteria-based and patient specific. Phases and time frames are designed to give the clinician a general sense of progression. Progression through the phases may vary in individuals with concomitant injuries/procedures such as graft choice, donor site, chondral injury, meniscal injury, and ligament injury. These Guidelines are specific to bone-tendon-bone grafts. For hamstring grafts, quadricep tendon grafts, allografts, and concomitant surgeries, see appendix 1. Follow physician modifications as prescribed. Copyright 2019-2020 by Hospital for Special Surgery. All rights reserved. Page 2 of 22 KNEE ANTERIOR CRUCIATE LIGAMENT (ACL) Reconstruction Post-Operative Guidelines Pre- operative Phase PRECAUTIONS Avoid pain with ROM and strengthening exercises Modify or minimize activities that increase pain and/or swelling Use appropriate assistive device as needed ASSESSMENT Lower Extremity Functional Scale (LEFS) International Knee Documentation Committee (IKDC) SANE ACL RSI Numeric pain rating scale (NPRS) Swelling Quality of quadriceps contraction Lower extremity (LE) AROM and PROM LE flexibility
• Consider blood flow restriction (BFR) program with FDA approved device if patient cleared by surgeon and qualified therapist available • Hip-gluteal progressive resistive exercises o May introduce Romanian Dead Lift (RDL) toward end of phase • Hamstring strengthening (unless hamstring autograft) • Calf strengthening
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