ACL Reconstruction — Allograft

UCLA Department of Orthopaedic Surgery Sports Medicine · Thomas Kremen MD

Weight-Bearing

WBAT immediately post-op; TDWB wks 0-2, partial wks 2-4, WBAT wks 4-6; crutches + brace x6 weeks

Key Restrictions

Brace locked in full extension for ambulation and sleeping wk 1; crutches + brace x6 weeks (allograft — slower revascularization than autograft); brace unlocked wks 1-6 for rehab/sleep; brace only in chaotic situations wks 6-12; brace optional after 12 weeks; no OKC hamstring work x6 weeks if concurrent meniscal repair/transplant; functional brace may be recommended during sports 1-2 years post-op

Timeline & Phases

5 phases: Phase I (0-6 wks, TDWB→partial→WBAT, quad sets/SLR/heel slides/patellar mob, pool once sutures removed, biking/leg press/theraband from wk 4, flexion to 90 deg), 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 progressing eccentric, CKC activities, slide board proprioception, pool running/swimming no breaststroke), Phase IV (6-9 months, walk/jog progression, forward/backward running — requires 70% strength + full ROM + no PF irritation + MD clearance), Phase V (9 months+, cutting/jumping/plyometrics/sport-specific drills, RTS with MD clearance)

Notes

Allograft — crutches + brace extended to 6 weeks vs 4 weeks for BTB autograft due to slower revascularization; PT 1x/wk Phase I, 2-3x/wk Phases II-III, discharge after functional progression; concurrent meniscal repair: avoid OKC hamstring x6 wks + possible extended brace/crutch time; pool immediately once sutures removed; functional brace for sports 1-2 years; Thomas Kremen MD, UCLA Sports Medicine; PatientPop hosted protocol

Surgeon / Author

Thomas Kremen MD