ACL Reconstruction with Patella Tendon or Hamstring Autografts Rehabilitation Guidelines

ACL Reconstruction with Patella Tendon or Hamstring Autografts Rehabilitation Guidelines

Introduction

This protocol provides a structured rehabilitation plan following ACL reconstruction using either patella tendon or hamstring autografts. The focus is on protecting the graft, restoring mobility, and progressively rebuilding strength and function. Each phase builds on milestones to ensure safe and effective recovery.

Post-Surgery Rehabilitation Phases

Inpatient Phase (Immediate Post-Op)

Goals:

1. Document Progress:
   • Record the intra-operative and immediate post-operative ROM achieved.
2. Manage Pain and Inflammation:
   • Use ice, elevation, and prescribed analgesics as needed.
3. Initiate Joint Mobility:
   • Start active elbow exercises including flexion, extension, pronation, and supination once the drain is removed.
4. Maintain Adjacent Joint Mobility:
   • Perform scapula, neck, shoulder, wrist, and hand exercises to maintain range of motion (ROM) and circulation.
5. Functional Use of Arm:
   • Encourage light activities with no lifting.
6. Nighttime Support:
   • Some patients may require a Mayo brace locked in extension for 3 months (refer to post-op notes).

Key Instructions:

• Sling use: Only for comfort; discontinue as soon as tolerated.
• Refer to outpatient physiotherapy within 1 week.

Outpatient Rehabilitation Phases

Phase 1: 0–2 Weeks

Goals:

• Pain and Inflammation Control:
  • Continue ice and elevation.
  • Encourage proper wound care and healing.
• Restore Passive ROM:
  • Achieve pre-operative passive ROM through consistent exercises.

Key Activities:

• Begin active and active-assisted ROM exercises for the elbow (flexion, extension, pronation, supination).
• Encourage scapular setting and upper limb exercises.

Milestones at 2 Weeks:

• Pain, inflammation, and muscle inhibition are well managed.
• Return to pre-operative sleep patterns.
• Achieve pre-operative passive ROM.

Phase 2: 2–6 Weeks

Goals:

• Increase Active ROM:
  • Gradually progress to pre-operative active ROM for the elbow.
• Introduce Strengthening:
  • Incorporate gentle strengthening exercises for the arm and upper limb as tolerated.

Key Activities:

• Progress functional use of the arm and hand for light activities.
• Gradually reduce restrictions while monitoring for discomfort.

Milestones at 6 Weeks:

• Achieve pre-operative active ROM.
• Pain-free functional use of the arm for light activities.

Returning to Activities

• Light Duties: At 4 weeks.
• Heavy Duties: At 6 weeks, based on progress and comfort.

Contact Information

• Consultant Secretary: 07810 356433
• Sulis Hospital Physiotherapy: 01761 422388
• Circle Health Group Bath Clinic Physiotherapy: 01225 838767
• St. Joseph Physiotherapy: 01633 820321

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