Phase 3. Weeks 5-6 (Visits: 1-2)

Phase 3 of rehabilitation focuses on gaining fuller range of motion and keeping a close eye out for early complications.


General observation Partial (25-50%) weight bearing when:

- Pain controlled without narcotics

- Hemarthrosis controlled

- ROM 0-100°

- Muscle control throughout ROM
  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
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
  - 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  
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