Moderators: Arun, Boopathi, Robin, baskar, AJIN, MDK-Physio
Author Post
Robin
Sun Dec 20 2015, 05:45PM
Keep looking around. There's always something you've missed.

Registered Member #4
Joined: Thu Jul 08 2004, 06:56AM
Location: Kollam, Keralam, INDIA
Posts: 2120

General considerations
  • All times are to be considered approximate, with actual progression based upon clinical presentation 
  • Patients are full weight bearing with the use of crutches, a walker, or a cane to assist walking until they are able to demonstrate good walking mechanics 
  • Early emphasis is on achieving full extension equal to the opposite leg as soon as able
  • No passive or active flexion range of motion greater than 90° for the first two weeks
  • No two-legged biking or flexion exercises for at least two weeks. Well-leg biking is fine
  • Regular manual treatment should be conducted to the patella and all incisions so they remain mobile
  • Early exercises should focus on recruitment of the vastus medialis obliquus (VMO)
  • No resisted leg extension machines (isotonic or isokinetic) at any point in the rehabilitation process
  • Driving is permitted once your leg is strong and coordinated to react safely to avoid an accident. Driving is often resumed after the first week or two and when all pain medications/narcotics are no longer needed. Also, surgical leg and type of car are considered before being cleared to drive. Ask your PT if you are ready to safely return to driving
Week 1:
  • Goal is to allow the medial arthrotomy to heal and decrease swelling
  • MD visit on post-op Day 1 to change dressing and review home exercise program
  • Icing, elevation, and aggressive edema control (i.e. circumferential massage, compression wraps)
  • Straight leg raise exercises (standing and seated), and passive and active ROM exercises
  • OK to gently bend knee < 90° 1 - 2x per day
  • Initiate quadricep/adduction/gluteal sets, gait training, balance/proprioception exercises
  • Well-leg cycling and upper body conditioning
  • Soft tissue treatments and gentle mobilization to the posterior musculature, patella, and incisions to avoid flexion or patella contracture
Weeks 2 - 4:
  • Clinic visit at 14 days for suture removal and check-up
  • Continue with home program, progress flexion range of motion, gait training, soft tissue treatments, and balance/proprioception exercises
  • Incorporate functional exercises as able (i.e. seated/standing marching, hamstring carpet drags, hip/gluteal exercises, and core stabilization exercises)
  • Aerobic exercise as tolerated (i.e. bilateral stationary cycling as able, UBE, pool workouts once incisions are healed.)
Weeks 4 - 6:
  • MD visit at 4 weeks post-op.
  • Increase the intensity of functional exercises (i.e. progress to walking outside, introducing weight machines as able)
  • Continue balance/proprioception exercises (i.e. heel-to-toe walking, assisted single leg balance). Slow-to-normal walking without a limp
Weeks 6 - 8:
  • Add lateral training exercises (i.e. lateral steps, lateral step-ups, step overs) as able
  • Incorporate single leg exercises as able (eccentric focus early on)
  • Patients should be walking without a limp and range of motion should be <10° extension and >110° flexion
Weeks 8 - 12:
  • Begin to incorporate activity-specific training (i.e. household chores, gardening, sporting activities)
  • Low-impact activities until after Week 12
  • Patients should be weaned into a home/gym program with emphasis on their particular activity/sport


Copied from : stoneclinic.com

Back to top

Sponsored Links

 

Jump:     Back to top

Syndicate this thread: rss 0.92 Syndicate this thread: rss 2.0 Syndicate this thread: RDF
Powered by e107 Forum System