This document, authored by Jared T. Lee, MD, outlines a rehabilitation plan for patients following a complex knee surgery involving multiple repairs and reconstructions.
The document details six phases of rehabilitation, each with specific:
- **Restrictions:** Guidelines for weight-bearing (touch-down), brace usage (locked at 0 degrees), range of motion limits, and activity restrictions (e.g., no supine knee extension, no hamstring curls or stretches in early phases, no valgus or lateral patellar stress).
- **Therapeutic Exercises:** Prescribed activities focusing on passive, active, and active-assisted range of motion (PROM, AROM, AAROM), edema control, pain management, strengthening exercises (quadriceps, hip, gluteal, core), closed-chain exercises, balance exercises, aquatic therapy, and progressive resistance exercises, leading to jogging and sport-specific activities.
- **Goals:** Objectives for each phase, such as reducing swelling and pain, protecting the surgical repair, restoring range of motion, increasing strength, restoring a normal gait pattern, improving lower extremity strength, and progressing to functional and sport-specific activities.
- **Criteria for Progression:** Benchmarks for transitioning to the next phase, including achieving range of motion goals, performing a Straight Leg Raise (SLR) without extension lag, having no change in pain or effusion, demonstrating quadriceps control, achieving a normal gait pattern, and passing specific sports tests (6-month and 9-month tests).
The phases progress from initial post-operative care with touch-down weight-bearing and a locked brace to full return to activity and sports, with increasing exercise intensity and functional demands. The document also mentions specific strength indices (hamstring and quadriceps) and a Y Balance anterior reach test as part of the discharge criteria, along with physician clearance.
