ACL Reconstruction — Allograft with Meniscus Repair

UCLA Department of Orthopaedic Surgery Sports Medicine · Thomas Kremen MD

Weight-Bearing

TDWB/NWB wks 0-4 with two crutches; WBAT wks 4-6; no WB when knee flexed >90 deg wks 0-4

Key Restrictions

Brace locked extension wk 1; brace unlocked to 0-90 deg wks 2-6; crutches + brace x6 weeks; NWB/TDWB wks 0-4; WBAT wks 4-6 with no WB when knee flexed >90 deg; no OKC hamstring work x6 weeks; brace optional after 12 weeks; functional brace recommended during sports 1-2 years; pool once sutures removed; no breaststroke swimming Phase III; stricter WB restrictions than allograft-only protocol (NWB/TDWB x4 wks vs TDWB x2 wks)

Timeline & Phases

5 phases: Phase I (0-6 wks, brace locked x1 wk then unlocked 0-90 deg, TDWB/NWB→WBAT at 4-6 wks, quad sets/SLR/heel slides/patellar mob/pool, biking + leg press from wk 6), Phase II (6-8 wks, discontinue brace/crutches when full ext + SLR without lag, CKC — wall slides/mini-squats/4-way hip/balance/stationary bike, aquatic gait normalization), Phase III (8 wks-6 months, full ROM, Stairmaster/Nordic Trac, knee ext 90-45 eccentrics, CKC activities, pool running/swimming no breaststroke), Phase IV (6-9 months, walk/jog progression/running — requires 70% strength + full ROM + MD clearance), Phase V (9 months+, cutting/jumping/plyometrics/sport-specific, RTS with physician clearance)

Notes

Allograft + meniscal repair variant; stricter WB than allograft-only: NWB/TDWB x4 wks, no WB when knee >90 deg; brace ROM limited 0-90 deg wks 2-6; no OKC hamstring x6 wks; Phase II begins at 6 wks (vs 6 wks allograft-only); no breaststroke swimming Phase III; PT 3-9 months; functional brace for sports 1-2 years; Thomas Kremen MD, UCLA Sports Medicine; PatientPop hosted protocol

Surgeon / Author

Thomas Kremen MD