ACL Reconstruction — Hamstring Autograft

Brigham and Women's Hospital · Dept. of Rehabilitation Services

Weight-Bearing

PWB with crutches and brace wk 0-1; partial weight bearing progressing to FWB with normal gait wks 1-4; crutches/brace for ambulation 4 wks

Key Restrictions

Protect graft revascularization (8 wks) and fixation (8-12 wks); flex to 90 deg only Phase I; avoid hyperext >10 deg; delay hamstring strengthening x 12 wks; very gentle hamstring stretching at 1 wk; brace locked ext x 1 wk, unlock <90 wks 1-3, wean wks 3-4

Timeline & Phases

5 phases: Phase I (0-4 wks, brace and PWB to FWB, protect graft and fixation), Phase II (4-12 wks, after full extension and SLR without lag), Phase III (12 to 18-20 wks, after >=120 deg flexion and no patellofemoral pain), Phase IV (4.5-5 to 6-7 months, full pain-free ROM), Phase V (6-7+ months, return to sport); supervised PT 4-7 months

Notes

Hamstring-specific; longer graft fixation protection (8-12 wks vs 4-6 wks BPTB); CKC quad strengthening delayed to Phase II; for meniscus repair/transplant defer to meniscus protocol. [Archived copy — original Brigham and Women's Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2026-04-20.]

Surgeon / Author

Dept. of Rehabilitation Services

Published

2007