ACL Reconstruction — Hamstring Graft Over-the-Top (Adolescent)

UW Health Sports Medicine · UW Health Sports Rehabilitation & Sports Medicine Physician Group

Weight-Bearing

PWB progressing to WBAT; brace locked in extension during all WB/walking x 6 weeks

Key Restrictions

Brace locked x 6 wks for all WB; ROM 0-90 x 4 wks; avoid aggressive hamstring activities early (donor site); fixation weaker than adult; no impact until Y balance >95% LSI and Biodex <30%; ROOT repair: TDWB locked x6 wks

Timeline & Phases

Phase I (0-6 wks: PWB to WBAT, locked brace x6 wks, ROM 0-90) -> Phase II (6+ wks: normalize gait, unlock brace, CKC) -> Phase III (11-12 wks+: strength, RFD, no impact; Y balance >95%, Biodex <30%) -> Phase IV/V (RTS at 9+ months)

Notes

Over-the-top technique (no femoral tunnel) for adolescents with partially closed growth plates; fixation less strong than adult; 9-12 months PT; NMES and BFR included; Spectrum class; surgeon-specific meniscal precautions (Baer/Cotter/Day/Smith/Spiker vs. Scerpella/Sheean); UW Health Sports Medicine, Madison WI

Surgeon / Author

UW Health Sports Rehabilitation & Sports Medicine Physician Group