Posterolateral Corner (PLC) Reconstruction

UCLA Department of Orthopaedic Surgery - Sports Medicine · Thomas Kremen MD

Weight-Bearing

NWB x 4 wks; WBAT advancing to FWB at 6 wks; D/C brace when gait non-antalgic

Key Restrictions

Pre-op: NWB with crutches; brace stays on for all exercises Phase I (open only for muscle stimulator or patellar mobs); brace locked at 0° wks 1-4; brace locked at night/unlock for PT wks 4-6; WBAT advancing to FWB and brace discharged when gait non-antalgic at wk 6; no hamstring work until wk 10; OKC knee extension begins at 6 wks; CKC exercises begin at 12 wks; swimming/exercise bike begins at 6 wks; running/agility pool or unweighted at 4-6 months; RTS ~6 months or longer

Timeline & Phases

Pre-op: NWB with crutches, instruction in post-op activities | Phase I (wks 1-4): NWB, brace locked at 0°, ankle pumps, patellar mobilization, passive extension to zero, quad sets/adductor sets/glut sets/SLR in flexion | Phase II (wks 4-6): continue NWB, brace locked at night/unlock for PT, PROM/AAROM to tolerance; wk 6: WBAT → FWB, brace unlocked and D/C when non-antalgic gait, exercise bike/swimming for ROM, OKC knee extension begins; wk 10: initiate hamstring work against gravity progressing to PRE | Phase III (wk 12): bicycle, pool program (strengthening/swimming/walking), mini-squats, lateral/front lunges, wall squats, leg press, knee extension, hip AB/AD, light hamstring curls if necessary, Stairmaster | Phase IV (4-6 months): pool/unweighted running/agility drills, continue strengthening, gradual return to sports at 6 months or longer

Notes

Pre-operative NWB with crutches required; standalone PLC reconstruction (compare to Kremen ACL+PLC protocol 307009.pdf for combined reconstruction); brace stays on for all Phase I exercises; no hamstring work until wk 10; OKC knee extension permitted at wk 6; CKC at wk 12; pool/swimming from wk 6; RTS at 6 months or longer; Kremen MD UCLA PatientPop practice site

Surgeon / Author

Thomas Kremen MD