POST-OPERATIVE REHABILITATION FOLLOWING PCL RECONSTRUCTIVE SURGERY - Download Now DOC

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POST-OPERATIVE REHABILITATION FOLLOWING PCL RECONSTRUCTIVE SURGERY
SPORTS INJURY SURGERY, OSWESTRY.

WEEK/ IDEAL CRITERIA RANGE OF WEIGHT BEARING REHABILITATION GUIDE GOALS
MONTH MOVEMENT
WEEK 0 - 2 Locked at 5 in a As tolerated with  Isometric Quadriceps (Q) 1. Minimise pain.
brace. elbow crutches.  Patella mobilisations 2. Reduce swelling.
IMMEDIATE (AVOID  Circulatory exercises 3. Improve confidence.
PHASE hyperextension)  Abduction, Adduction, Gluteal work 4. Promote distal circulation.
 Upper body 5. Restore independence.
 Core stability 6. Prevent post-operative
 Flexibility complications.
WEEK 2 - 4  Full active and Gradually increase Gradually wean off  Progress/ continue above 1. As above.
passive extension range of movement crutches.  Gait re-education 2. Straight leg raise (SLR)
MAXIMUM  Decrease in post- within hinged brace,  Active open kinetic chain (OKC) Q, with no lag.
PROTECTION operative swelling up to 90F. +/- resistance 3. Encourage early Q
PHASE I  Minimal LIMIT to 60F during  Active Q work near full extension strength.
discomfort active and resisted with resistance as tolerated 4. Promote normal gait
exercises.  Proprioception exercises pattern.
 Early/ protected Closed kinetic chain 5. Improve proprioception.
(CKC) work, <45F 6. Prevent AKP.
 VMO exercises 7. Prevent scar adherence.
8. Encourage patient
compliance
WEEK 4 - 6  SLR no lag No limit to range of Full.  Progress/ continue above 1. As above.
 Mobilising movement.  Increase CKC work, <45F 2. Improve cardio-vascular
MAXIMUM independently LIMIT to 60F during  Static cycle, gradually increase performance.
PROTECTION with no aids active and resisted cadence/ resistance/ duration as
PHASE II exercises. tolerated/ required.
 Isokinetic Q, 0°-60°

 RJ & AH Orthop and Dist NHS Trust Oswestry, 2007

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WEEK/ IDEAL CRITERIA RANGE OF WEIGHT BEARING REHABILITATION GUIDE GOALS
MONTH MOVEMENT
WEEK  30 min. ‘Power’ Remove brace at  Progress/ continue above 1. As above.
6 - 12 walk week 8 if isolated  Stepper, increasing intensity and 2. Improve Strength, Power
 Adequate dynamic PCL procedure was duration as tolerated/ required and Endurance overall.
CONTROL proprioception performed.  Rower, gradually increase stroke/ 3. Full range of movement.
PHASE  Isometric Q, 80% No limit to active resistance/ duration as tolerated/
that of contra- range of movement required.
lateral (ROM).
 Minimal/ no
effusion
 Pain free
MONTH  Row 2000m Remove brace at  Progress/ continue above 1. As above.
3-6 within 15 min., month 3 if a combined  OKC Hamstring (H) work, adding 2. Improve H strength
moderate PCL and postrolateral resistance/ speed of contraction/ 3. Regain lower limb muscle
LIGHT resistance setting corner procedure was repetitions as progression balance.
ACTIVITY  Solid end point to performed.  Low speed isokinetic H 4. Improve lower limb
PHASE reverse Lachman No limit to resisted  Swimming function.
and LCL test ROM.  Dynamic hydrotherapy, including
 FROM pool running
 Early plyometrics
 Light agility

 RJ & AH Orthop and Dist NHS Trust Oswestry, 2007

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WEEK/ IDEAL CRITERIA RANGE OF WEIGHT BEARING REHABILITATION GUIDE GOALS
MONTH MOVEMENT
MONTH  Isometric H, 80%  Progress/ continue above 1. As above.
6-9 of contra-lateral  Non predictable agility training 2. Improve strength and
side  Introduce high speed isokinetics control at speed.
ACTIVITY  Proprioception  Running, begin on sprung surface and 3. Improve speed of force
PHASE 90% of contra- gradually increase pace/ duration/ production.
lateral side inclination as tolerated/ required 4. Improve quality of
 Plyometric training movement.
 Sport specific training 5. Bias to specific function/
sport
6. Preparation for full return to
sport/ activities.
MONTH 9  Q and H, 90% of  Earliest return to sport 1. Unrestricted confident
contra-lateral side. function.
HIGH  Symptom free
LEVEL training
ACTIVITY  No residual
PHASE complications
 Psychologically
prepared

 RJ & AH Orthop and Dist NHS Trust Oswestry, 2007

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 RJ & AH Orthop and Dist NHS Trust Oswestry, 2007

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