Multi-Ligament Knee Reconstruction — Knee Multi-Ligament Reconstruction/Repair (ACL/PCL +/- MCL/LCL/PLC)

University of Virginia Orthopaedic Surgery

Weight-Bearing

50% WB for 6 weeks

Key Restrictions

50% WB for 6 weeks; brace locked at 0° weeks 0-2 (may unlock only for prone ROM under PT supervision); brace unlocked 0-90° weeks 2-6; ALL ROM exercises must be performed prone or side-lying for first 6 weeks; no active strengthening with knee flexion; prevent anterior/posterior tibial translation and rotation

Timeline & Phases

Phase 1 (0-6 wks): brace locked 0° then unlocked 0-90°, 50% WB, quad sets/SLR, NO active strengthening with knee flexion, patella mobilizations, prone ROM exercises, Russian stim in extension; Phase 2 (6-10 wks): wean crutches to FWB, prone flexion 120°+, CKC exercises, balance, step-ups; Phase 3 (10-16 wks): progress to full ROM, HS strengthening prone, advance quad; Phase 4 (4-6 months): plyometrics, walk-jog; Phase 5 (6+ months): return to sport/work

Notes

Critical: all ROM exercises prone or side-lying only for first 6 weeks; no active strengthening with knee flexion in Phase 1; prevent tibial translation with ankle weights (increase anterior translation, use cautiously); quad exercises in home program; covers ACL, PCL, with or without MCL, LCL, PLC

Published

12/2024