ACL Reconstruction With Meniscal Repair (Inside Out)

Weeks 0-2:

• TDWB, Brace locked at 0 degrees for ambulation and sleeping
• ROM: 0-90º with emphasis on full extension
• Patella mobilization
• SLR supine with brace locked at 0 degrees, Quad Sets
• Ankle Pumps
• Short crank (90mm) ergometry

Weeks 2-4:

• Transition to PWBAT ~50% to full WBAT by 4 weeks post op.
• Brace locked in full extension until post op week 4-6
• No weight bearing past 90° for ACL with meniscal repair
• ROM: 0-125 degrees (Maintain full extension)
• Active knee extension to 40 degrees
• Standard (170mm) ergometry (when knee ROM > 115 degrees)

Weeks 4-6:

• Full WBAT leg in extension,
• brace down 60-90 by 6 weeks anticipate brace removal at that time
• Leg Press (80-0 degree arc)
• Mini Squats / Weight Shifts
• Proprioception training
• Initiate Step Up program
• Avoid Tibial Rotation until 6 weeks

Weeks 6-14:

• D/C Brace
• Progressive Squat program
• Initiate Step Down program
• Leg Press, Lunges
• Isotonic Knee Extensions (90-40 degrees, closed chain preferred)
• Agility exercises (sport cord)
• Versa climber/Nordic Track
• Retrograde treadmill ambulation

Weeks 14-22

• Begin forward running (treadmill) program when 8” step down satisfactory
• Continue Strengthening & Flexibility program
• Advance Sports-Specific Agility Drills
• Start Plyometric program

> 22 weeks:

• Advance Plyometric program, Return to Sport (MD Directed)
• **May require Functional Sports Assessment (FSA) 5-6 months post op for clearance to return to sport