ACL Reconstruction — with Quad Tendon Graft and Meniscal Repair

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

Weight-Bearing

WBAT with crutches (brace locked 0° extension) x6 weeks; DC crutches when quad control returns and full extension achieved; FWB wean from brace at 6 weeks if full extension and no SLR lag

Key Restrictions

Flexion limited to 90 deg x6 weeks (meniscal repair); brace locked 0° for ambulation x6 weeks; no open chain resistive exercises with weights Phase II; no dynamic valgus throughout; no downhill walking/running/skiing/biking x4.5 months; earliest RTS 9 months; must pass return to sport test

Timeline & Phases

5 phases: Phase I (0-3 wks, WBAT brace locked, PROM 0-90°), Phase II (3-6 wks, AROM 0-90°, theraband ok), Phase III (6 wks-3 months, DC brace for gait, CKC — mini squat/lunges/bridges, pool), Phase IV (3-5 months, jogging treadmill wk 12 progressing to 75% speed, agility drills), Phase IV continued (5-8 months, plyometrics, cutting, pivoting, RTS testing at 9 months)

Notes

Meniscal repair drives 90° flexion restriction x6 weeks and delays earliest RTS to 9 months; return to sport criteria: quad/hamstring strength ≥90% uninvolved, SL hop and vertical jump ≥90% uninvolved, no effusion or quad atrophy, full acceleration/deceleration; Andrea Dillon PT 6/21/16; Brian Gilmer MD June 2016

Surgeon / Author

Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Andrea Dillon PT

Published

June 2016