Week 1 – 2
- Pain and swelling management with regular ice packs
- The patient will notice a bulky bandage that can come off in 48 hours
- There will be multiple small surgical scars that need to be kept covered with small sticky dressings.
- Ice the back of thigh due to hamstring harvest
- Early Weight bearing Mobilisation with crutches for support
- Knee Extension splint or locked knee brace for first 2 weeks
Week 2 – 6
- Wean off brace but keep crutches for balance
- Achieve 90 degrees of flexion by 4 weeks and full flexion by 6 weeks
- Closed chain quadriceps rehabilitation
- Maintain balance and provide gait training
- Let the knee hang at edge of chair and perform heel slides
- Avoid manual patella mobilisation
- Start mini squats and proprioceptive exercises
Week 6 – 12
- Continue closed chain exercises
- Commence bike work
- Resistance exercises on bike and with therabands
- Hamstring stretches
- Core strengthening
- Proprioceptive exercises
- Increase quadriceps strengthening programme
Week 12 onwards
- Start more dynamic exercises and strength training
- Start light running
- Delay impact training if there is significant chondral pathology
- Initiate plyometrics
- Progression to cutting motion and any sports specific rehabilitation depends on individual patient response and needs
