multiligament knee reconstruction rehab protocol

�m�� <> endobj ��uq�s�&B�My��~/��d <> Multiligamentous Reconstruction Phase I (1 – 5 days post-op) • Wound care: Observe for signs of infection • Gait: Non-weight-bearing • Brace: Locked in extension 24 hr/day • ROM: o AROM to hip and ankle o Maintain full passive knee extension o Gentle stretching of hamstrings and gastroc/soleus • Strengthening: Quad sets The following postoperative rehabilitation protocol is implemented for patients who undergo revision multiligament knee reconstruction; minor variations may be tailored to the pattern of ligament reconstruction. 9|�/��=5�'7�ik+[0�YF�y�;�x�t��\�"ݵ�r��7*ո=�(�s R��WUu�$�ׯ~��e:_��~��U�躩l\�F�6�e?e~��;p��M2�V�r6�+�qv�Hnz�b�Jt03��@��. However, early postoperative physical therapy and range of motion consistently lead to improved outcomes. Use crutches to assist with walking – you will be NON WEIGHT BEARING x6 weeks with brace locked in 30 degrees of flexion following surgery. 2 0 obj endobj Full range of motion is especially vital to long-term outcomes, and patients should aim to obtain 0° to 90° of knee flexion within the first 2 weeks after surgery. �j_aК��g}�Ktv$[vk�\��3�4\T))� \��nC�r��o�Y��bS��=9��Υi�da�Gk�I�;��yg)Cz&Y#��qu�yƉ.�6Dۣ�T�Y#Y��2�0n�b��q~�|�+��oI�ɘDQ7dn��cV�@w�\�⠱d�!X)&3��B�� n�_+��m�s�h��q6ȁXc��)چ�4��7�[��J�k�=��R�[��6�3a��Y�9y�L�,�-��4�tc�Q��eo ��s2�Ѳ�U��n�Q{浾S�U3��M3۶�f�ü]4��MDNZ��,�i�GJ�ؖL��N��6>�8>��6��=W�i��;p�r ��z��+��g��\,��K佫]�-�I��"��Q1��4��yC��C=��|��m�� ߨT�Q�!�s��샪a&�u��e�9R��fT6��U��v}�nS-�H;ʜ�}�B3��3C�Gk��o�n�_WX�-_��~G.��v7w��`�?��2��˘�sI�>%cT�0\G�q��v;rshq��0��~�ldw��]�n��uY��}�sp��08�M�z߻�@�R��^��h�H|��!��0��h�*��]谬��o9�j��Q��V�w�a�&j��:�e�u�U�L��4��+'�l,{�~a�]�}�91/I��F ܍�=��^�˵�U@v[�6�R�3�Rږ� With you undergoing surgery to reconstruct your ligaments you will be given a rehabilitation protocol that will state what you should be doing and over what time period. endobj Osteochondral Allograft Transplant (OCA) PATELLAR TENDON EXCISION (JUMPER’S KNEE) %PDF-1.5 <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> �}��j��{3 ��~t��v�s�$ȸ�*��ŲB5��.�V*w�װ��! Key concepts. Early passive ROM exercises are very important, as is preventing excessive anterior and/or posterior tibia translation. <> A wide constellation of injuries can occur with causes sufficiently traumatic to produce bicruciate ligament deficiency, and this technical report will describe diagnosis, treatment and rehabilitation for a knee dislocation with lateral injury … To avoid liquid extravasation due to the arthroscopic part of the procedure, which can jeopardize the Appointments • Begin rehabilitation 1-3 days after surgery and continue 2-3 times per week Rehabilitation Goals • Protect the post-surgical knee • Restore normal knee extension and improve scar and patellar mobility • Eliminate effusion (swelling) • Restore leg control Initiate regaining knee flexion T��U�_V$\U��gk��#h� �Ma�{��R��%�A��B�$C��C�JhH�V��¬M+!y`�EhZ ��24�xfh��Y�S�O@!��o�\K�J�ͤ)b��;p�AUT��眦a!M�,��!CS��udh�hF��B�Ǩ� %�� Brace: Locked in extension for ambulation for 4 weeks for ACL/PCL and/or MCL reconstruction, then unlocked for ambulation for 2-4 weeks until normal gait is established. Arthrofibrosis and de-creased ROM can be seen following a violent knee inju-ry which requires extensive multiligament reconstruction surgeries, occasionally re-quiring a secondary surgery for further restoration of stream However, anyone recovering from an injury or surgery is free to use them. Ice pack with knee in full extension after exercise PHASE II: ~2-4 WEEKS POSTOPERATIVE GOALS: • Normal gait • AROM 0-60 degrees AMBULATION AND BRACE USE: Brace – Weeks 2-3: 0-45 degrees – Weeks 3-4: 0-60 degrees EXERCISES: Continue appropriate previous exercises Scar massage when incision healed AAROM, AROM 0-60 degrees ACL Reconstruction with Meniscal Repair (All Inside) ACL Reconstruction with Meniscal Repair (Inside Out) ... MULTILIGAMENT KNEE RECONSTRUCTION. ACL Reconstruction. 6 0 obj %�� sitting to laying down) o Do not pivot on your surgical side Weight Bearing Walking • Initially brace locked, crutches A well-guided rehabilitation protocol after a multiligament reconstruction should focus on graft protection and functional outcomes including regaining motion, strength, and function. 3. Hip Gluteus Medius – General Information Gluteus Medius – Rehab Protocol Hamstring Repair – General Information Hamstring Repair – Rehab Protocol Hip Arthroscopy – Rehab Protocol Knee ACL FCL Reconstruction ACL Reconstruction ACL Reconstruction with Meniscal Repair (All Inside) ACL Reconstruction with Meniscal Repair (Inside Out) ACL Reconstruction with … SLUCare Sports Medicine and Shoulder Surgery specialists developed the following physical therapy protocols for SLUCare clinicians to use when recommending treatment and rehab for SLUCare patients. Multiligament knee injuries constitute a complex and challenging entity, not only because of the diagnosis and reconstruction procedure itself, but also because of the rehabilitation programme after the index procedure. It is not meant Week 6-12 months (Phase III): … Appendix: Multiligament Reconstruction Protocol at Mayo Clinic Sports Medicine Center, Rochester, MN. Progression to the next phase is based on Clinical Criteria and/or Time Frames as 3 0 obj Locked in extension for ambulation for 12 weeks for PLC reconstruction. The rehabilitation and overall success of the procedure can be affected by associated injuries to the knee such as damage to the meniscus, articular cartilage or other ligaments of the knee. <>/Metadata 192 0 R/ViewerPreferences 193 0 R>> We recommend prone exercises to use gravity to counter this pull. 2. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. Multiligament reconstruction performed in a left knee, with the patient in a supine position and the limb secured in a leg holder (Mizuho OSI). <> The following is a more detailed hamstring ACL rehabilitation protocol useful for patients and physiotherapists. In a revision total knee arthroplasty, or in cases where there is more connective tissue involvement, Phase I and II should be progressed with more caution to ensure adequate healing. This protocol is based on a review of the best available scientific studies regarding knee rehabilitation. It is by no means intended to serve as a … Multiligament Knee Injury (ACL/PCL +/- MCL/PLC) Rehabilitation following surgery for multiligament knee injury (MLKI) or knee dislocation is an essential element of the treatment to achieve a full recovery. %PDF-1.5 endobj x��Ymo�6� ��a��"�PH�t��Y�a�~P�6�X��t��w�[�H(��K�WU�}�W5y�f~U��jS��Y��ˋ�[N� �O��0��I�( �)�XB�//Y��./""��_^��䯗�I�R"MMF4ᒦ�T��?��}/b�H�H |/�f��[�^�C�� ?��$d~��|wC��}�_��+n��F��6)U�lPD'>V >��CnJr x��][oG�~7��0��{�=��e��:��,(��ۤ"R'��tU%R�5"Gճ��$ ͫ��TW׽N��\}��7՟�|��f3�_.Ϋ�O߭��u��r��Z-O�=��[]��7�K��WկϟyYg*oL%��nϟ��S�|��/�|��w�jj�w�?��ʫZ(��}�_��'_]��?�� None Decreased pain Decreased swelling 1-Straight leg raises in brace 2-Calf pumps Multiple Knee Ligament Reconstruction Rehabilitation Protocol Curtis A Bush 871-878-5300 The intent of this protocol is to provide the therapist and patient with guidelines for the post-operative rehabilitation course after surgery. Rehabilitation Guidelines for Knee Multi-ligament Repair/Reconstruction Phase IV ( 3 moths to 6 months following surgery) 333 38th St. New York, NY 10016 (646) 501 7047 newyorkortho.com! PCL or ACL reconstruction-Multiligament Knee Protocol With LCL, posterolateral, or MCL reconstruction Physical Therapy Protocol Randy Clark MD 1 of 1 1/10 WEIGHT BEARING Range of Motion Goals EXERCISES 0-2 weeks Non-weight bearing in immobilizer with crutches. stream Postoperative Rehabilitation of Multiligament Knee Reconstruction: A Systematic Review Conclusion: The rare nature of MLKI hinders the ability to create a standardized rehabilitation protocol. Injuries to the knee involving multiple ligaments occur in a variety of circumstances and require careful assessment and planning. Pattern of multiligament knee injuries and their outcomes in a single stage reconstruction: Experience at a tertiary orthopedic care centre ... MLKI with reconstruction could help patients to return to their pre operative level of sports activities with a proper rehabilitation protocol. kŊt��i�G�!�XO�� ƣ�EzÊ�kk($VR��Bb��`�!��6�H!��Q�� SH�|��uCR�� endobj The goal of our postoperative rehabilitation protocol is to promote knee range of motion while protecting the reconstructed ligaments. Range of Motion Exercises Brace ROM: Full; no brace Weight bearing: full Therapeutic Exercises Initiate progressive jogging program <>>> %��\��n��a|�4�Y2^�YI��i*#�1D� ��|�R�U`x�@�}+$h�5��\ D�j�x��gno#��h��X�/VQj��i.�x��2�N�4�^=�o�8��p�C�$8��Ɍ�ӓ��U�� ҧJ�R�j�_�^��(*[>��*� � Multiligament Knee Injury (ACL/PCL +/- MCL/PLC) Rehabilitation following surgery for multiligament knee injury (MLKI) or knee dislocation is an essential element of the treatment to achieve a full recovery. <> <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Between May 2005 and February 2007, patients underwent single-stage multiligament knee reconstruction. 1. Goals: https://www.physio-pedia.com/Multiligament_Injured_Knee_Dislocation A systematic review of severe multiple-ligament knee injuries demonstrated that early mobility was associated with better outcomes in comparison with immobilization and yielded fewer range-of-motion deficits, especially in … endobj 3 0 obj Multilig Knee Reconstruction Prot•ocol Stretch collagen • Provide controlled stress/prevent abnormal collagen cross-link realignment/scar tissue formation • Protect graft fixation • Critical: 0 extension by week 2, 90 flexion by week 4. <> Early rehabilitation consisted of initiating a standardized physical therapy protocol on postoperative day 1 involving removal of the extension splint for quadriceps activation and … All patients followed a standard rehabilitation protocol. In multiligament knee reconstructions that include the PCL, the hamstrings have a tendency to pull the tibia posteriorly when the knee is flexed, which can potentailly stretch your graft. Multiligamentous Knee Reconstruction Rehab Program General Information The intent of this protocol is to provide the therapist and patient with guidelines for the post-operative rehabilitation course after multi-ligament knee reconstruction. ��?�y�zz�Ln�'2L>�G5��>~�y~1=��*>��/��(�㿪w{��8�>u�R�� A�c�X��%��Ֆ�Tu"j!x��d1g�5�\�*N> �jɊiM��I$�V@gjM��"5�"�6�\��P{ A high level of suspicion and a comprehensive clinical and radiographic examination are required to identify all injured structures. This physical therapy protocol applies to primary total knee arthroplasty. 1 0 obj endobj *�,�YB3^��%4�=��.� ? Careful consideration is needed before patients attempt to have their knee reconstruction performed using this “rehabilitation shortcut” technique, as by doing so they are committing to having a mechanical non-biological graft which may achieve all of their short term objectives and rapid return to sport and other commitments , but may present additional … o Keep your knee straight and elevated when sitting or laying down. 5 0 obj Post-operative Rehabilitation Protocol Multiple Ligament Injury Reconstruction/Repair (ACL, PCL, +/- MCL, LCL, or PLC) Overview: § The goals of this protocol are to protect the reconstructions while preventing knee stiffness. PT general form for online reference. endstream X5��㙎�boYG��Zn!Kd��X�ؽ*w�� n��~�V1>�Y�8�K��Y��8w9R��=��ؿX]�- �\[�v��OeEP��. 1. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the Ohio State Sports Medicine physical therapy team and sometimes, other healthcare providers. υ�#B7�^vu�D�/�LD��D�c_�}��:�9�:�)0%�>п*��PW/8i�Q��-�.��c�E�&�g2�=��p� Place pillows under knee to support brace locked at 30 degrees, it may be comfortable to purchase a donut to offload pressure over incision on your bottom. • Active Prone knee bend: Lying on your stomach, with your brace unlocked N… KNEE REHABILITATION PROTOCOL. Inclusion criteria were minimum 2-year follow-up and multiligament knee injury including the FCL/PLC. Post-operative Rehabilitation Protocol Knee Multiple Ligament Injury Reconstruction / Repair (ACL, PCL, +/- MCL, LCL, or PLC) The goals of this protocol are to protect the reconstructions while preventing knee stiffness. 2 0 obj It is by no means intended to be a substitute for one’s clinical decision- ion rehab protocol utilizing a dynamic PCL brace, such as the PCL Rebound brace, is recommended to prevent posterior tibial sag. Do not rest with a towel placed under the knee o Do not actively kick your knee out straight; support your surgical side when performing transfers (i.e. Because multiple ligaments are being reconstructed your rehabilitation protocol will be individualised for you. Early passive ROM exercises are very important, as is preventing excessive anterior and/or posterior tibia translation. Physical Therapy Protocols. *g.�߶�@��F�Dⳁ��]�-��Ӌu�cWo;#̳4��4�>��,��|j;��P�}f�B2�D��i��4�p��5�4�&a��Ԝ�0H�� stream endobj May remove for ROM exercises. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. 4 0 obj Multi-Ligament Reconstruction Rehabilitation Protocol Phase I: Weight Bearing Brace ROM Therapeutic Exercises 0-2 Weeks Tow Touch weight bearing Locked in full extension None Quad sets, ankle pumps, SLR, hip ab/adduction, hamstring/calf stretch, calf press with theraband, patellar mobs 2-6 Weeks Tow Touch weight bearing Locked in full 1 0 obj 7 0 obj Concomitant meniscal, chondral and … <> A. x��\��*R$. Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. Surgery: s/p RIGHT/LEFT MULTILIGAMENT RECONSTRUTION – (ACL / PCL / MCL / LCL / MPFL ) Date of Surgery:_____ Frequency: 1 2 3 4 times/week Duration: 1 2 3 4 5 6 Weeks WEEKS 1-6 ___ Ambulate TTWB with Bledsoe Brace locked @ 0° extension ___ Avoid Valgus Loads to Knee … endobj 4 0 obj Department of Rehabilitation Services Physical Therapy PCL Reconstruction Protocol The intent of this protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone a PCL or PCL/ACL reconstruction.

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