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Rehabilitation Guidelines for ACL Reconsturction with Meniscal Repair (Inside Out)


Please note that these instructions are general guidelines to be followed; however, any written or verbal instructions provided by Dr. Verma or either Physician Assistant supersede the instructions below and should be followed.

Post-Operative Rehabilitation Guidelines for ACL Reconstruction with Meniscal Repair (Inside Out)

0-2 Weeks:

  • TDWB, Brace locked at 0 degrees for ambulation and sleeping
  • ROM: 0-90º with emphasis on full extension
  • Patella mobilization
  • SLR supine with brace locked at 0 degrees, Quad Sets
  • Ankle Pumps
  • Short crank (90mm) ergometry

2-4 Weeks:

  • Transition to PWBAT ~50% to full WBAT by 4 weeks post op. Brace locked in full extension until post op week 4-6
  • No weight bearing past 90° for ACL with meniscal repair
  • ROM: 0-125 degrees (Maintain full extension)
  • Active knee extension to 40 degrees
  • Standard (170mm) ergometry (when knee ROM > 115 degrees)

 4-6 Weeks:

  • Full WBAT leg in extension, brace down 60-90 by 6 weeks anticipate brace removal at that time
  • Leg Press (80-0 degree arc)
  • Mini Squats / Weight Shifts
  • Proprioception training
  • Initiate Step Up program
  • Avoid Tibial Rotation until 6 weeks

6-14 Weeks:

  • D/C Brace
  • Progressive Squat program
  • Initiate Step Down program
  • Leg Press, Lunges
  • Isotonic Knee Extensions (90-40 degrees, closed chain preferred)
  • Agility exercises (sport cord)
  • Versaclimber/Nordic Track
  • Retrograde treadmill ambulation

14-22 weeks:

  • Begin forward running (treadmill) program when 8” step down satisfactory
  • Continue Strengthening & Flexibility program
  • Advance Sports-Specific Agility Drills
  • Start Plyometric program

22 weeks:

  • Advance Plyometric program, Return to Sport (MD Directed)
    • **May require Functional Sports Assessment (FSA) 5-6 months post op for clearance to return to sport

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