Considerations Before Setting up a Plan:

ACL rehabilitation

Considerations Before Setting up a Plan:

:one:Acute Phase:

:fire:In the acute management phase, there are some considerations to protect the surgical repair and allow healing without compromising ROM.

:eight_pointed_black_star:Protection and Restrictions:

:arrow_right:ROM:

Patient can move freely either actively or passively throughout the available ROM within pain tolerance.

:arrow_right:Bracing:

Bracing may not be beneficial on the long run, some clinicians prefer placing the knee in an immobilising brace which is then replaced with a c-hinge functional knee brace once femoral nerve block wears off following the surgery.A safer environment may not require bracing.

:arrow_right:Weight-Bearing:

While full weight-bearing may be tolerated in the first few weeks, partial weight bearing is preferred to protect scarring, allow healing and restore joint homeostasis as soon as possible.

:arrow_right:Stationary bike:

Introduced on day 10 or once 110° knee ROM is achieved. However, you may permit a small range of pelvis rocking as a way of facilitating ROM if the whole range is still restricted.

:arrow_right:Resistance weight-bearing strength training:

Delayed until 6 weeks after surgery to avoid scar hypertrophy and stiffness.

:two:The intermediate rehabilitation phase goals:

:arrow_right:Knee flexion within 10° of the contralateral side.
:arrow_right:Quadriceps index greater than 60%.

:yin_yang:Quadriceps Index is :’'the ratio of involved-side quadriceps strength to uninvolved-side quadriceps strength".

:three:Late rehabilitation phase goals:

:arrow_right:Quadriceps index greater than 80%
:arrow_right:Normal gait pattern
:arrow_right:Full knee ROM
:arrow_right:Knee joint effusion equal to a grade of trace or less.
:arrow_right:Assessed using the modified stroke test.