Unlocked for ambulation 090, remove for sleeping 02 weeks. Materials and methods results of 11 aclpcl patients had been matched. Nonsurgical treatment patients should meet the criteria for isolated pcl injury table 1. Download pdf, 32kb tibial stress fractures rehab protocol. Posterior cruciate ligament rehabilitation protocol it is important to understand that all time frames are approximate and that progressions should be based on individual monitoring. This summary of all the current literature was provided such that further improvements. Clinical examination andor pcl stress radiographs to objectively verify healing of pcl after week 15 continue exercises and protocol from weeks 18 set and reps structure to emphasize muscular power development 3 sets of 48 reps sportspecific agility exercises noncontzlt return to play following clearance by the operating physician. Posterior cruciate ligament reconstruction this protocol is a guideline for your rehabilitation after posterior cruciate ligament reconstruction. Surgical reconstruction of the posterior cruciate ligament pcl is technically demanding. If greater than 900 of knee flexion is performed, this must be done with an anterior drawer force to prevent posterior subluxatlon.
Rehabilitation after injury to the medial collateral. Millett, md, msc sports medicine and orthopaedic surgery 3 acl reconstruction rehabilitation protocol one of the most common complications following acl reconstruction is loss of motion. Avoid greater than 900 of knee flexion for the first 6 weeks po st injury. The pcl is a very large ligament, located posterior to the acl, comprised of 2. Additionally, a small, nondisplaced pcl bony avulsion with grade iii laxity can also reportedly be treated with progressive weight. Rehabilitation of isolated and combined posterior cruciate ligament injuries. Provide objective criteria for safe return to sports. Rehabilitation guidelines for knee multiligament repair. Posterior cruciate ligament pcl nonoperative treatment consists of a stepbystep rehabilitation protocol and is well described. Associate professor of orthopaedics chief division of sports medicine tel. Rehabilitaion protocol for posterior cruciate ligament. Pcl to be protected for the first 12 weeks, with posterior tibial translation to be restricted during this time. Please refer to the ohio states sports medicine website for rehabilitation guidelines specific to other procedures and conditions, as appropriate.
The intent of this protocol is to provide the clinician with a guideline for a nonoperative rehabilitation course of a patient with an isolated posterior cruciate ligament injury. Posterior cruciate ligament reconstruction rehabilitation. Injuries of the posterior cruciate ligament pcl occur less frequently than those of the anterior cruciate ligament acl. Brace locked at 0 degrees extension for first week no open chain hamstring strengthening or stretching phase i 1 day 5 weeks post op wound careedema. Rehabilitation program following surgical reconstruction of the pcl weekmonth rehabilitation protocol weeks 1 to 6 long leg knee brace locked in full extension with no weight bearing for the first 6 weeks patellar mobilization begin rangeofmotion exercises 0 to 70. The mcl connects the femur and tibia medially on the inside and resists valgus knee buckling in knee motion. The aim of this study is to report the results of a consecutive series of patients who underwent the same surgical technique for isolated pcl reconstruction and were. You may vary in your ability to do these exercises and to progress from one phase to the other. It goes from rest phase i to strengthening exercises phase iv. Pcl and acl reconstruction postop physical therapy dr. No open chain hamstring strengthening or isolated hamstring exercises.
Since its launch, the rebound pcl brace has been recommended in rehabilitation protocols for pcl injuries worldwide and is used by many key opinion leaders. Posterior cruciate ligament pcl reconstruction rehabilitation protocol the following is a protocol for postoperative patients following pcl reconstruction. It is designed for rehabilitation following a pcl injurytear, typically grade i and ii. Pcl non operative rehabilitation guideline sanford health. Alaia, md assistant professor of orthopaedics division of sports medicine tel. You may vary in your ability to do these exercises and. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a reconstruction of their posterolateral corner with or without a concomitant pcl reconstruction. Complete rest for the first 48 hours, after that, let pain be the guide to the speed. Noyes knee institute rehabilitation protocol after pcl. Posterior cruciate ligament tears functional and postop rehab.
We follow the detailed rehabilitation program as published by dr laprade and his. Rehabilitation following surgery for posterior cruciate ligament pcl injury is an essential element of the treatment to achieve a full recovery. Postoperative rehabilitation protocol pcl andor posterolateral corner reconstruction 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. Posterior cruciate ligament info and rehabilitation guide. A nonaggressive rehabilitation protocol which protects the graft from. Mcl injury restrict motion to sagittal plane until week 46 to allow healing of mcl. Posterior cruciate ligament pcl reconstruction post. This leaflet outlines what happens during and after surgery, outlines the risks and benefits, and gives advice and exercises to help you recover if you decide to go ahead with the operation. Pcl non operative rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Feb 27, 2016 pcl non operative rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Reconstruction surgery of the posterior cruciate ligament pcl has not yet been fully standardized. Millett, md, msc sports medicine and orthopaedic surgery 3 acl reconstruction rehabilitation protocol one of the most common complications following acl reconstruction is. The following rehabilitation guidelines are specific to patients who have undergone a posterior cruciate ligament pcl reconstruction surgical procedure. Physical therapy will begin immediately postoperatively and will continue 36 months.
Cole,md,mba weight bearing brace rom exercises phase i 04 weeks full in brace 01 week. Pcl nonoperative rehabilitation protocol for physiotherapists this protocol is a guide only for isolated pcl injuries that have been appropriately assessed and deemed suitable for conservative management. A common mechanism of injury to the mcl occurs when a force is applied to the outer knee while the foot is planted, causing the knee to move inward. Provide a logical sequence of progressive drills for presports conditioning 3. Postoperative rehabilitation protocol pcl andor posterolateral corner reconstruction overview. Locked in full extension for ambulation and sleeping 26 weeks. Posterior knee pain may mean the patient is progressing too qulckly guidelines. Consider brace for exercise and periods of activity if severe sprain andor patient has pain. Locked in full extension for ambulation and sleeping 14 weeks. The rehabilitation protocol could be compared with an accelerated pcl reconstruction protocol. Rehabilitation after injury to the medial collateral ligament. It is by no means intended to be a substitute for ones clinical decision.
Aims to control swelling, maintain the ability to straighten and bend the leg and to begin strengthening exercises for the leg muscles when possible. Hep will be performed as instructed by physical therapist beginning with one preop appointment. Pcl reconstruction protocol brigham and womens hospital. Pdf rehabilitation after posterior cruciate ligament. Posterior cruciate ligament reconstruction brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave.
Lowe this rehabilitation protocol has been developed for the patient who has posterior cruciate ligament pcl reconstruction using a secure graft with internal fixation. The rehabilitation protocols are very different from acl reconstruction and the outcomes are less good. Clinical examination andor pcl stress radiographs to objectively verify healing of pcl after week 15 this protocol is adopted from pierce, c. Isolated posterior cruciate ligament reconstruction. Posterior cruciate ligament pcl reconstruction postoperative.
Kssta 2012 this study evaluated the current literature for both functional and postoperative rehabilitation for pcl tears. This protocol is a guideline for your rehabilitation after posterior cruciate ligament reconstruction. The protocol described here incorporates early mobilisation with an emphasis on extension. The physician reserves the right to either advance or delay this protocol as deemed necessary. Do not perform any exercises requiring isolated hamstring contraction for 4 weeks, including hamstring curls, isometrics, or excessive stretching. Oah returntosport after pcl nonoperative rehabilitation clinical examination a pcl injury patient is typically less aware of the spraintear. Chattanooga, tn 423 6242696 this protocol is a guideline for your rehabilitation after posterior cruciate ligament reconstruction. Kngf evidence statement for anterior cruciate ligament. 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.
May be reproduced, as is, for clinical, educational, and research. Posterior cruciate ligament rehabilitation phase 6. Posterior cruciate ligament reconstruction is an operation to replace your torn posterior cruciate ligament pcl and restore stability to your knee joint. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. Rehabilitation guidelines for posterior cruciate ligament. Please call your doctor if you are having a problem with your knee or if you need clarification of these. Pcl acl reconstruction postop protocol 20191021t16. They usually do not hear or feel a pop or tear, as is common in acl and mcl injuries, and they report vague symptoms of. It is by no means intended to be a substitute for ones clinical decision making regarding the progression of a. Pcl rehabilitation protocol rosenberg cooley metcalf. The protocol is unique and differs from acl rehabilitation in that knee flexion beyond 90 places tension on the newly reconstructed pcl and is to be avoided early on. Posterior cruciate ligament pcl reconstruction postoperative protocol. Foot flat weight bearing with crutches and brace locked in ext. Postoperatively, an accelerated rehabilitation program allows the.
Early activity following pcl repair can lead to increased laxity. It is not clear which factors enhance the healing process, but its likely that a well established rehabilitation protocol with a support to prevent posterior translation. Cole,md,mba weight bearing brace rom exercises phase i 06 weeks heel touch wb in brace 02 weeks. Maintain strength, endurance and function initiate plyometric program. 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 pcl acl reconstruction. Oah returntosport after pcl nonoperative rehabilitation. Consider brace for exercise and periods of activity if. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving preinjury level of activity. Protocol for nonoperative treatment of pcl tears precautions. The most common cause of pcl tears figure 3 are sports injuries 37% and trauma 56%. Posterior cruciate ligament rehabilitation tends to follow slower rehabilitation protocols than those for acl injuries. Rehabilitation program for posterior cruciate ligament pcl andor multiligament reconstruction october 2018 this protocol is designed to assist you with your rehabilitation after surgery and should be followed under the direction of a physiotherapist.
Isolated pcl injury rehabilitation conservative treatment. Posterior cruciate ligament repair with suture tape augmentation. Several pcl reconstruction and pcl repair techniques have been described in the literature, but no. Posterior cruciate ligament rehabilitation protocol. Specific changes in the program will be made by the physician as appropriate for the individual patient. Arthroscopically assisted combined anterior and posterior cruciate. With and without pcl reconstruction rehabilitation protocol. The pcl is tight when the knee is bent, so most pcl injuries occur at that time. Posterior cruciate ligament tears functional and postop. Rehabilitation protocols help patients most in noting the specific timing of activities and exercises relevant to their condition.
The pcl reconstruction rehabilitation is unique in that extreme knee flexion places a higher amount of stress on the newly reconstructed pcl. 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 pcl acl reconstruction. Aims to control swelling, maintain the ability to straighten and bend the leg and to begin strengthening exercises for the leg muscles when possible duration 2 weeks rest from aggravating activities. May 01, 2010 reconstruction surgery of the posterior cruciate ligament pcl has not yet been fully standardized, and associated rehabilitation protocols have not been clearly defined. Pclacl and 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 pcl acl reconstruction. Safely recondition the injured area for the demands of sports activity. Posterior cruciate ligament reconstruction rehab protocol. Outcomes after posterior cruciate ligament pcl reconstruction in. Accelerated rehabilitation programme this programme is provided as a guide to assist the therapist in making clinical decisions regarding the progress of the rehabilitation of patients following pcl reconstruction using hamstring tendon graft. Operative pcl rehabilitation protocol this protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. This rehabilitation program is designed to return the individual to their activities as quickly and safely as.
Rehabilitation should obviously be individualised and may. Aclanterior cruciate ligament, pclposterior cruciate ligament. Unlocked for ambulation, remove for sleeping as tolerated quad sets, patellar mobs. No resisted knee flexion exercises for 4 weeks postop.
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