ACL Reconstruction — Hamstring Autograft

Mammoth Orthopedic Institute / Sierra Park PT · Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Erin…

Weight-Bearing

PWB with 2 crutches x1 week; FWB with crutches wks 1-4 (progress as quad control and normal gait mechanics achieved); wean crutches fully as tolerated

Key Restrictions

Brace locked in extension until 1st PT visit; wks 1-3 unlock to 90 deg as quad control allows; avoid hyperextension >10 deg; protect graft re-vascularization x8-12 weeks; hamstring curl resistance only from wk 12; no return to sports until 6-7 months; MD clearance required

Timeline & Phases

4 phases: Phase I (wks 1-4, PWB-FWB quad control, patellar mob, SLR, mini squats), Phase II (wks 4-12, FWB, CKC strengthening, stair gait, balance progression), Phase III (wks 12-18, running treadmill wk 12 then land wks 16-18, 85% strength by wk 14), Phase IV (wks 12-18+, plyometrics, agility, cutting, return to sport 6-7 months with MD clearance)

Notes

References Brigham and Women's Hospital and SOS Medical ACL protocols; return to sport criteria: SL hop and 3-hop tests 85% uninvolved, quad/hamstring strength 85% uninvolved, MD clearance at month 6-7; Erin Stansbury PTA April 2016; Brian Gilmer MD April 2016

Surgeon / Author

Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Erin Stansbury PTA

Published

April 2016