ACL Reconstruction — (BTB - Bone-Tendon-Bone)

Mountain Orthopaedics · Mountain Ortho Clinical Team

Weight-Bearing

WBAT with crutches wk 1 (balance only); encourage FWB ASAP; advance per tolerance

Key Restrictions

Knee immobilizer 48 hrs only (exception: concomitant MCL tear); avoid all open chain x 12 wks; open chain max 25 lbs wks 13-16; BTB bridge program begins wk 12; functional brace for contact sports only

Timeline & Phases

Week 1 (limited activity, WBAT, SLR 50 2x/day); Wks 2-6 (ROM: 0-120 wk 4, 0-130+ wk 6; CKC when no limp); Wks 7-8 (aggressive ROM, aerobic); Wks 9-12 (jogging/swimming/golf with MD OK at wk 8, plyometrics); Wks 13-16 (OC up to 25 lbs, retro training); Wks 17-24 (return to sport)

Notes

Surgeon protocol; patellar glides 4x/day wks 1-6; return to sport: painless ROM = contralateral, no effusion, quad control, excellent agility/proprioception; Get Set Train Smarter app recommended; functional brace evidence-based for contact football/soccer/rugby

Surgeon / Author

Mountain Ortho Clinical Team