ACL Bone-Patella-Bone Reconstruction

Rehab Protocol

Keys to a Successful Outcome

  • Crutches should be used after surgery until the patient feels safe walking without them.

  • Ice should be used liberally for the first two weeks

  • The graft construct/knee is weakest and most susceptible to failure about 6 weeks from surgery.  After that, it starts to heal in and become stronger.

Phase
Brace
ROM
WB
Exercises
Weeks 0-4
Weeks 0-1: Locked in full ext; Weeks 1-4: unlocked for ambulation, remove for sleeping*
As tolerated
Full in brace
Heel slides, quad/ham sets, patellar mobs, gastroc/soleus stretch; SLR w/ brace in full ext until quad strength prevents ext lag; side-lying hip/core
Weeks 4-12
Discontinue at day 28 if patient has no ext lag
Full
Full
Begin toe raises; progress quad/ham exs; stationary bike; progress hip/core training
Weeks 12-16
None
Full
Full
Advance closed chain strengthening; progress proprioception activities; begin stairmaster/elliptical at 8 wks; forward jogging at 12 wks.
Weeks 16-24
None
Full
Full
Week 16: Begin jumping Week 20: advance to sprinting, C.O.D. drills; initiate plyo program and sport-specific drills**
>6 Months
None
Full and pain-free
Full
Gradual return to sports participation

 

*Brace may be removed for sleeping after first post-operative visit (day 7-10).  Crutches can be used until it is safe to walk without them.