Multi-Ligament Knee Reconstruction — ACL and PCL Reconstruction

NYU Langone Health · Dr. Daniel J. Kaplan, MD

Weight-Bearing

NWB

Key Restrictions

NWB x6 wks; dynamic PCL brace locked in full extension x1 wk, unlocked for exercises starting POD 7; prone ROM only in Phase 1 (avoid gravity tension on PCL); no active knee flexion or open-chain hamstring isometrics x8 wks; no carpet drags (PCL contraindicated); running criteria include quad bilateral comparison >80% and hamstring >110%

Timeline & Phases

Phase 1: 0-6 wks (NWB, prone ROM 0-90, brace locked); Phase 2: 7-12 wks (TTWB then WBAT by wk 8, wean brace, AAROM/PROM 0-125); Phase 3: 13-20 wks (FWB no brace, closed chain, walking/pool running); Phase 4: 4-6 months (plyometrics, running program — acute at 4-5 months, chronic at 5-6 months); Phase 5: 6-9 months (gradual RTS)

Notes

Prone-only ROM in Phase 1 is PCL-specific (avoids posterior tibial translation from gravity). Carpet drags contraindicated with PCL reconstruction

Surgeon / Author

Dr. Daniel J. Kaplan, MD

Published

2025-01