REHABILITATION PROTOCOL:ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION WITH TIBIALIS ANTERIOR ALLOGRAFT
Phase I (Weeks 0-4)
Weightbearing: As tolerated with crutches (may be modified if concomitant meniscal repair/meniscal transplant or articular cartilage procedure is performed)
Hinged Knee Brace:
Weeks 0-2: Locked in full extension for ambulation and sleeping
Weeks 2-4: Unlocked for ambulation and removed while sleeping
Range of Motion – AAROM 🡪 AROM as tolerated
Therapeutic Exercises
Quad/hamstring sets
Heel slides
Non-weightbearing stretch of the Gastroc/Soleus
Straight-Leg Raise with brace in full extension until quad strength prevents extension lag
Phase II (Weeks 4-6)
Weightbearing: As tolerated – discontinue crutch use
Hinged Knee Brace: Discontinue brace use when patient has achieved full extension with no evidence of extension lag
Range of Motion – Maintain full knee extension – work on progressive knee flexion
Therapeutic Exercises
Closed chain extension exercises
Hamstring curls
Toe raises
Balance exercises
Progress to weightbearing stretch of the Gastroc/Soleus
Begin use of the stationary bicycle
Phase III (Weeks 6-16)
Weightbearing: Full weightbearing
Range of Motion – Full/painless ROM
Therapeutic Exercises
Advance closed chain strengthening exercises, proprioception activities
Begin use of the Stairmaster/Elliptical
Can Start Straight Ahead Running at 12 Weeks
Phase IV (Months 4-6)
Gradual return to athletic activity as tolerated
Maintenance program for strength and endurance
