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Rehabilitation protocol after posterolateral corner surgery - Phase 3. Weeks 5-6 (Visits: 1-2)
Submitted by admin on October 20, 2009 - 1:44pm.
Phase 3 of rehabiltation focuses on gaining fuller range of motion and keeping a close eye out for early complications.
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Part 7 of a course by Dr Frank Noyes on Posterolateral corner injuries of the knee
Phase 3 of rehabiltation focuses on gaining fuller range of motion and keeping a close eye out for early complications.
Below I have given you an overview of our own rehabilitation protocol for this phase, and on the right you will be able to click through to the detailed protocols for each phase.
Phase 3. Weeks 5-6 (Visits: 1-2)
| General observation | Partial (25-50%) weight bearing when: - Pain controlled without narcotics - Hemarthrosis controlled - ROM 0-100° - Muscle control throughout ROM |
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| Custom medial unloader brace or hinged soft tissue brace | ||
| Avoid hyperextension, varus loads | ||
| Evaluation | Goals | |
| Pain | Mild/No RSD | |
| Effusion | Minimal | |
| Patellar mobility | Good | |
| ROM minimum | 0-110 degrees | |
| Muscle control | 3/5 | |
| Inflammatory response | None | |
| Frequency | Duration | |
| Range of motion | ||
| 3x/day, 10 mins | ROM (passive, 0°-110°) | |
| Patella mobilization | ||
| Hamstring, gastroc-soleus stretches | 5 reps x 30 secs | |
| Strengthening | ||
| 2x/day, 20 mins | Straight leg raises (flexion: ankle weight, < 10% of body weight) | 3 sets x 10 reps |
| Isometric training: multi-angle (90°, 60°, 30°) | 2 sets x 10 reps | |
| Closed-chain | ||
| - Mini-squats | 3 sets x 20 reps | |
| Knee extension (active, 90°-30°) | 3 sets x 10 reps | |
| Aerobic conditioning (patellofemoral precautions) | ||
| 2x/day, 10 mins | UBC | |
| Stationary bicycling | ||
| Gait retraining (high risk for stretching reconstruction with resumption of weight bearing) | ||
| Muscle control quads & hams | ||
| Walk with toe-out gait, avoid toe-in varus position | ||
| Observe gait for any varus thrust or hyperextension | ||
| Smooth stance phase flexion pattern | ||
| Modalities | ||
| As required | electrical muscle stimulation | 20 minutes |
| cryotherapy | 20 minutes | |
| Goals | ROM 0°-110° | |
| Control inflammation, effusion | ||
| Muscle control | ||
| Early recognition complications (motion, RSD, patellofemoral) | ||
| 50% weight bearing |
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