Rehabilitation Timeline After Surgery

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Questions and Answers

What is the recommended time frame for starting partial weight-bearing after immobilization?

Immediate - 3w (correct)

3w - 6w

Immediate - 1w

1w - 3w

What is the primary benefit of achieving full weight-bearing without crutches within 10 days after ACLR?

Improved quadriceps function (correct)

Enhanced knee stability

Improved patellofemoral pain management

Faster return to normal activities

What is the primary focus of the first 2 weeks of the clinical phase?

Breaking the vicious circle of limitation, swelling, reflex spasm, and pain (correct)

Pain management and proprioception

Soft tissue restrictions and proprioception

Inhibited muscles and social aspect

At what range of motion can a patient progress to phase 2 of the rehabilitation protocol?

0 - 90° Signup and view all the answers

What is the primary purpose of immobilization and bracing in the ACLR rehabilitation protocol?

To protect the operated knee during the early rehabilitation phase Signup and view all the answers

When can a patient start jogging as part of the rehabilitation protocol?

3m - 4m Signup and view all the answers

What is the primary goal of range of motion exercises in the ACLR rehabilitation protocol?

To improve flexibility and range of motion Signup and view all the answers

What is the recommended time frame for starting full weight-bearing after immobilization?

3d - 6w Signup and view all the answers

What is the significance of proprioception feedforward to the brain in the ACLR rehabilitation protocol?

It improves balance and reduces the risk of re-injury Signup and view all the answers

What is the purpose of the kinematic part of the rehabilitation protocol?

To integrate the knee to the lower limb chain Signup and view all the answers

What is the criteria for progressing to phase 2 of the rehabilitation protocol?

Knee effusion well controlled, adequate quadriceps control, normal gait pattern, and knee range of motion of at least 0-90° Signup and view all the answers

What is the primary consideration for the rehabilitation protocol between 2-6 weeks after ACLR?

Soft tissue restrictions and myofascial contracture Signup and view all the answers

What is the primary benefit of achieving early quadriceps strength after ACLR?

Improved knee stability and reduced risk of re-injury Signup and view all the answers

What is the primary focus of the rehabilitation protocol between 12-18 weeks after ACLR?

Inhibited muscles and social aspect Signup and view all the answers

What is the primary goal of the Accelerated Program in the first 2 weeks post-op?

To prevent arthrofibrosis and patello-femoral dysfunction Signup and view all the answers

What is the recommended range of motion for the safe zone in closed chain exercises?

0-40 degrees Signup and view all the answers

What is the purpose of using a CPM device in the rehabilitation protocol?

To achieve a range of motion of 90-110 degrees Signup and view all the answers

What is the recommended time frame for starting bike exercises after surgery?

After 1 week, if the patient can start Signup and view all the answers

What is the goal of patellar mobilization in the rehabilitation protocol?

To break down contractures of soft tissue Signup and view all the answers

What is the purpose of using electrical modalities in the Accelerated Program?

To reduce pain and inflammation Signup and view all the answers

Study Notes

Clinical Phase

Lymphatic massage may be necessary to address edema in the first 2 weeks post-op.
Patellar mobilization is important between 6-9 weeks post-op.
ROM should progress to full extension between 12-18 weeks post-op.
Weight shifting in different planes is crucial according to the surgical procedure.
Breakdown of contracture in soft tissue is essential.
Bike exercise can be started after 1 week if the patient can start.
It is important to avoid arthrofibrosis, patello-femoral dysfunction, and hamstrings tendinosis.

Accelerated Program

Post-op, electrical modalities should be used, with the leg at 0 degrees of extension.
CPM is used until 90-110 degrees of flexion is reached.
Bracing is discontinued if strength permits.
CKC exercises, such as mini squats, one-legged mini squats, step-ups, toe raises, hamstring curls, and active assisted exercises progressing to AROM and RROM, are essential.

Weight-Bearing

Full weight-bearing without crutches is achieved within 10 days, with a normal gait pattern.
This improves quadriceps function, prevents patellofemoral pain, and does not affect knee stability.

Clinical Phase Considerations

Release of the operated knee involves breaking the vicious circle of limitation, swelling, reflex spasm, soft tissue restrictions, pain, inhibited muscles, and proprioception feedforward to the brain.
Considerations in the clinical phase include histological changes, healing process, social aspect, and surgical procedures.

Variations in Rehab Protocols

Immobilization using a brace or splint is used for 0-2 months or 0-1 week, respectively.
CPM is started within 0-1 week.
ROM exercises are started within 0-1 week, with a goal of passive hyperextension to 90-115° flexion by 2 weeks.
Partial weight-bearing is started immediately to 3 weeks, and full weight-bearing is started as tolerated (3 days) to 6 weeks.
Jogging is started at 3-4 months, and full sporting activity is started at 4-9 months.

Criteria to Progress to Phase 2

Knee effusion must be well controlled.
Adequate quadriceps control must be demonstrated.
Normal gait pattern without assistive devices must be achieved.
Knee range of motion of at least 0-90° must be achieved.

Clinical Phase 2-6 Weeks

The integration of the knee to the lower limb chain involves combined movement of hip and ankle (kinematic part).
Transmission of load and reaction through the chain (kinetic part) is important.
Optimization of the connection results in normal walking with symmetry of both sides.

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Description

This quiz covers the rehabilitation timeline after surgery, including lymphatic massage, patellar mobilization, and weight shift exercises. It outlines the different phases of recovery, including edema management and contracture prevention.