ACL Reconstruction — (Criterion-Based)

University Orthopedics (Brown University) · University Orthopedics Sports Medicine Division

Weight-Bearing

WBAT with crutches as needed for optimal gait from early stage; D/C crutches when normal gait achieved

Key Restrictions

Brace discharged after first post-op visit if full active extension and SLR without lag achieved; criterion-based progression (not time-based); Tampa Kinesiophobia Scale and ACL-RSI administered at each phase; BFR allowed from 2 weeks post-op; no RTS until 46-52 weeks with multidisciplinary clearance

Timeline & Phases

Early Stage (0-2 wks): graft protection, swelling, ROM, quad activation, NMES; Early Stage Phase 2 (2-4 wks): full extension, flexion restoration, normalized gait, BFR; Mid Stage Phase 1 (4-10 wks): quad strength >60% contralateral, OKC 45-90 deg, CKC 12-20 RM, BFR/NMES; Mid Stage Phase 2 (10-16 wks): quad >75%, HS equal bilateral, jogging criteria, LSI >70%; Late Stage (16-28 wks): LSI >80-90%, plyometrics, agility, sport-specific drills; Late Stage Phases 3-5 (28-52 wks): reactive movement, sport simulation; RTS 46-52 wks: LSI >90%, hop tests >90%, mutual clinician-athlete clearance

Notes

Criterion-based protocol with detailed strength/functional benchmarks at each phase; includes Tampa Kinesiophobia Scale and ACL-RSI psychological readiness tools; BFR parameters specified; supplemental video library at universityorthopedics.com/therapy/videos.html; University Orthopedics (Brown University), Providence RI

Surgeon / Author

University Orthopedics Sports Medicine Division