Rehabilitation guidelines for posterior cruciate ligament. It is by no means intended to be a substitute for ones clinical decision. It is by no means intended to be a substitute for ones clinical decision making regarding the progression. Pcl non operative rehabilitation guideline sanford health. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving preinjury level of activity. Lowe this rehabilitation protocol has been developed for the patient who has posterior cruciate ligament. Posterior cruciate ligament pcl injury fact sheet introduction injury to the pcl is not as common as any of the other knee injuries see figure 1. Meniscal repair no modifications required, progress per. Surgical reconstruction is done by replacing the torn pcl with a graft. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Acl reconstruction protocol1 northwestern medical center.
Only a small number of protocols incorporate the use of specific objective. Knee pcl reconstruction rehabilitation program gundersen. Pcl reconstruction protocol brigham and womens hospital. Additionally, a small, nondisplaced pcl bony avulsion with grade iii laxity can also reportedly be treated with progressive weight. Goals are to increase strength, power and cardiovascular conditioning.
Acl reconstruction rehabilitation protocol one of the most common complications following acl reconstruction is loss of motion, especially loss of extension. Department of rehabilitation services physical therapy pcl reconstruction protocol the intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone a pcl or pclacl reconstruction. The protocol was constructed in a spreadsheet with a format that. Sports medicine physical therapy rehabilitation protocols. Nonsurgical treatment patients should meet the criteria for isolated pcl injury table 1. Brace knee immobilizer or fracture brace is used 24 to 48 hours after surgery.
Chondroplasty restricted weightbearing for 4 weeks. If there is a combined reconstruction involving both the pcl and the acl, then rehabilitation will progress according to the isolated pcl protocol. The intent of this protocol is to provide the clinician with a guideline for. Loss of knee extension has been shown to result in a limp, quadriceps muscle weakness, and anterior knee pain. Early activity following pcl repair can lead to increased laxity. The pcl reconstruction rehabilitation is unique in that extreme knee flexion places a higher.
Alejandro verdugo this rehabilitation protocol has been developed for the patient who has posterior cruciate ligament pcl reconstruction using a secure graft with internal fixation. Pcl nonoperative rehabilitation protocol page 1 of 3 bart eastwood d. Lowe this rehabilitation protocol has been developed for the patient who has posterior cruciate ligament pcl reconstruction using a secure graft with internal fixation. Posterior cruciate ligament reconstruction uw health. Alejandro verdugo this rehabilitation protocol has been developed for the patient who has posterior cruciate. Perform pres with tibia in internal rotation during early postop period to decrease mcl stress. The sports physical therapy service is an integral part of the sports medicine center and the department of.
Madison, wi 53718 rehabilitation guidelines for knee multi. The therapist must also be aware that the lateral structures of the knee act as secondary stabilizers to posterior translation and need to be guarded initially. Outcomes after posterior cruciate ligament pcl reconstruction in patients with isolated and combined pcl tears. Throughout this protocol, time references in weeks since. Nov 08, 2012 acl reconstruction rehabilitation protocol peter j. Madison, wi 53718 rehabilitation guidelines for posterior cruciate. Madison, wi 53718 rehabilitation guidelines for posterior cruciate ligament reconstruction the knee has three jointsthe patellofemoral joint knee cap, the tibiofemoral joint and the tibiofibular joint. Range of motion exercises are initiated at the surgeons discretion in the initial six weeks postoperatively. Anatomy knee multiligament 4 major ligaments rehabilitation. It is important to understand that all time frames are approximate and that progressions should be based on individual monitoring.
Pdf posterior cruciate ligament pcl is a major stabilizer of the knee joint. Grade iii tears may have an immobilization period prior to. Posterior cruciate ligament reconstruction postoperative rehabilitation protocol the range of motion allowed after posterior cruciate ligament reconstructive surgery is dependent. Mpfl reconstruction rehabilitation the following is a protocol for postoperative patients following medial patellofemoral ligament reconstruction. This rehabilitation protocol has been developed for the patient who has posterior cruciate ligament pcl reconstruction using a secure graft with internal fixation. Begin scar massage after incision site sloughsscar is. The pcl reconstruction fixation is not as sturdy as a typical acl fixation, so prevention of posterior tibia translation through the first eight weeks is paramount. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of. The following is a protocol for postoperative patients following pcl reconstruction. 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. Injury to the pcl can often be managed with nonoperative treatment. Pcl rehab sports medicine orthopedic surgeon houston, tx. No knee hyperextension or arom knee flexion exercises.
The intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone a. No modifications required, progress per patient tolerance and protocol. Patients must demonstrate specific functional criteria at each physical therapy visit before progressing to more advanced interventions. Millett, md, msc steadman hawkins clinic vail, colorado slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Madison, wi 53718 rehabilitation guidelines for knee multiligament repairreconstruction the knee joint is comprised of an articulation of three bones. Acl reconstruction rehab protocol general guidelines brace will remain locked until patient demonstrates good quadriceps control two to four weeks with weight bearing activities. This article illustrates gregory fanelli, mds surgical technique for the arthroscopic singlebundle, singlefemoral tunnel and doublebundle, doublefemoral tunnel transtibial pcl reconstructions. Fit for functional pcl brace to be used for sporting activities and more ballistic rehabilitation training. Wulf, md posterior cruciate ligament reconstruction. The pcl reconstruction rehabilitation is unique in that extreme knee flexion places a higher amount of stress on the newly reconstructed pcl. The newest anatomic pcl retroconstruction guide reduces the challenge.
To create a rehabilitation protocol following reconstruction of the posterior. Postoperative rehabilitation protocol pcl andor posterolateral corner reconstruction overview. Posterior cruciate ligament reconstruction postoperative rehabilitation protocol the range of motion allowed after posterior cruciate ligament reconstructive surgery is dependent upon the stability obtained at the time of surgery. Six of the other 8 study requirements consisting of a detailed. Posterior cruciate ligament rehabilitation protocol. Pcl reconstruction with the acufex director drill guide. Pcl andor posterolateral corner reconstruction overview. Pcl reconstruction with or without pl repairreconstruction. If wound is dry may leave open and cover with compressive sleeve. Frequent use of cryocuff andor ice with lower extremity elevated. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Cole,md,mba weight bearing brace rom exercises phase i 04 weeks full in brace 01 week. This protocol is for patients who have undergone pcl reconstruction. The intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone a pcl or pclacl reconstruction.
In particular, we intended to perform categorical analysis and discuss some critical points. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. No open chain hamstring strengthening or isolated hamstring exercises. Michael barrow pcl reconstruction rehabilitation protocol post op week post op month 1 to 2 3 to 4 5 to 6 7 to 12 4 to 5 6 to 9 9 to 12 brace v v v weightbearing.
Posterior cruciate ligament pcl reconstruction rehabilitation program introduction the posterior cruciate ligament pcl is the strongest ligament in the knee. Mcl injury restrict motion to sagittal plane until week 46 to allow healing of mcl. Posterior cruciate ligament pcl reconstruction with achilles allograft. The pcl reconstruction rehabilitation is unique in that extreme knee flexion places. The pcl is larger and stronger than the acl and is therefore another very important stabilizing ligament in the knee. Arthrex provides a comprehensive line of pcl reconstruction instrumentation options for a variety of pcl reconstruction techniques. The therapist must watch for patellar pain due to the increased tibial drop back present with a ruptured pcl. Brace knee immobilizer or fracture brace is used 24 to 48. Posterior cruciate ligament reconstruction rehabilitation protocol dr. Find pdfs of our most common rehabilitation protocols.
Immobilizer 3 days in extension until patient can transition into pcl brace pcl jack brace to be worn at all times, including rehabilitation and sleep minimum of 24 weeks goals pcl ligament graft protection ckdema reduction to improve passive rom and quadriceps activation address gait mechanics patient education therapeutic exercise. Associate professor of orthopaedics chief division of sports medicine tel. Edema control continue edema control until edema resolves typically 4 weeks or less. This can be removed once the femoral nerve block has worn off and an independent straight leg raise is achieved. Begin scar massage after incision site sloughsscar is formed. Chapter 41 posterior cruciate ligament reconstruction 479 midstance phase of gait. Rehabilitation guidelines for knee multiligament repair. The newest anatomic pcl retroconstruction guide reduces the challenge of pcl footprint targeting while simultaneously acting as a backstop to protect the neurovascular bundles. Begin patellar mobilizations 10 reps each direction tid. Pcl non operative rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible.
Rehabilitation guidelines for posterior cruciate ligament reconstruction. Pcl reconstruction protocol the intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone a pcl or pclacl reconstruction. Time frames for brace or crutches may be extended by dr. Acl reconstruction rehabilitation protocol peter j. Acl reconstruction postoperative rehabilitation protocol. Introduction proper rehabilitation after pcl surgery is essential to success. It is designed for rehabilitation following a pcl injurytear, typically grade i and ii. Begin the first 3 exercises below and add others gradually as tolerated.
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