PCL Reconstruction or Repair Protocol - Premier Bone & Joint Centers
PCL Reconstruction or Repair Protocol - Premier Bone & Joint Centers
PCL Reconstruction or Repair Protocol - Premier Bone & Joint Centers
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<strong>PCL</strong> <strong>Reconstruction</strong> <strong>or</strong> <strong>Repair</strong> <strong>Protocol</strong>Dr. LeveneI. First week postop:a. Brace locked 0 degrees, WBAT unless concomitant lesion prohibitsb. Elevate, ice, compression wrapc. Quad isometricsd. Patellar mobilizatione. Active ankle AROMf. No knee ROMII. Second to fourth week postop:a. Begin therapist assisted prone passive knee flexion with anteri<strong>or</strong> drawer f<strong>or</strong>ceapplied to proximal posteri<strong>or</strong> tibia, ROM not to exceed 0 to 90 degreesb. Continue quad isometrics, e-stim to quadsc. Side-lying straight leg raise in braced. Progress to supine SLR in bracee. No unopposed active hamstringsf. Crutches, WBAT, brace locked 0III. Fifth and sixth weeks postop:a. Gradually progress toward full prone passive flexion with therapist appliedanteri<strong>or</strong> drawerb. Aggressive patellar mobsc. Continue as above with quad developmentd. Wean off crutches, gait training WBAT, brace locked 0 to 90IV. Seventh and eighth weeks postop:a. AAROM with terminal stretch to achieve full, discontinue therapist appleddrawerb. No unopposed hamstrings strengthening (curls)c. Treadmill walking, may gradually increase inclined. Continued focus on quad strength and functione. Closed-chain c<strong>or</strong>d resisted strengthf. Begin two-leg quarter squatsg. Transition to functional knee brace as swelling permits, wean off nighttimebrace useh. May spin on stationary cycle without resistanceV. Nine to twelve weeks postop:a. Continue full-time use of FKB when upb. Progress to single-leg quarter squats when able
c. Increased duration and resistance on stationary cycle, RPM>60d. Increase incline on treadmill to 7-10 degrees, initiate backward treadmille. Continue closed chain strengthening with c<strong>or</strong>d resistance <strong>or</strong> light weightsf. Proprioception trainingg. Isometric hamstrings and gastroc strengthening beginsVI. Thirteen to sixteen weeks postop:a. FKB f<strong>or</strong> training onlyb. Advanced resistance training, primarily closed-chain, knee flexion angle not toexceed 90 degrees.c. Hamstring curls with resistance c<strong>or</strong>d, progressing to light weightsd. May jog on level ground in FKBe. Outdo<strong>or</strong> cycling ok, must remain in seatf. Stair-stepper ok in FKBg. Sp<strong>or</strong>tc<strong>or</strong>d resisted f<strong>or</strong>ward, backward, and lateral movementVII. Seventeen to twenty-four weeks postop:a. Continue weight training, extra emphasis on quad developmentb. Straight line running permitted, gradually progress to figure 8 runs, carioca, andcutting maneuvers (last couple of weeks)c. Plyometricsd. Slide and balance board, advanced proprioceptione. FKB f<strong>or</strong> w<strong>or</strong>kouts only, not ADLsVIII. Beyond twenty-four weeks postop:a. Sp<strong>or</strong>t-specific functional progressionb. Return to sp<strong>or</strong>t criteriai. Completed functional progressionii. Adequate muscle development, minimal to no effusioniii. Good Stabilityiv. FKB until 1 year postop<strong>PCL</strong> <strong>Reconstruction</strong> – Levene 4-03
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