Please see below the rehabilitation programme we have created based on the recommendations from ISAKOS (International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine), ESSKA (European Society of Sports Traumatology, Knee Surgery, and Arthroscopy), and the Moon Protocol. A detailed protocol is available at this link. Note that the rehabilitation ideally starts before surgery!
Phase 1: Preoperative Rehabilitation
Optimize knee range of motion through gentle stretching exercises.
Strengthen the quadriceps, hamstrings, and calf muscles.
Enhance proprioception and balance through stability exercises.
Control swelling and inflammation using techniques such as ice therapy, compression, and elevation.
Educate the patient about the surgery and postoperative expectations.
Phase 2: Early Postoperative Phase (Weeks 1-2)
Focus on getting to full extension within the first two weeks and gradually start flexion range of motion exercises.
Protect the healing graft by avoiding excessive stress or strain.
Begin early weight-bearing exercises with crutches or assistive devices as needed provided there are no meniscus repairs to be protected.
Focus on pain management through ice therapy, elevation, and medication.
Initiate gentle quadriceps and hamstring activation exercises..
Phase 3: Intermediate Phase (Weeks 2-6)
Progress weight-bearing exercises with a goal of weaning off crutches.
Improve quadriceps control and strength through closed-chain exercises.
Continue to work on range of motion and flexibility.
Incorporate functional exercises and neuromuscular training.
Start stationary biking for cardiovascular fitness.
Enhance joint stability through proprioceptive exercises.
Phase 4: Advanced Strengthening Phase (Weeks 6-12)
Increase intensity and resistance of strengthening exercises.
Focus on improving muscle strength, endurance, and power.
Include plyometric exercises to enhance dynamic stability.
Gradually reintroduce running and cutting maneuvers.
Begin sport-specific training and drills.
Address any remaining deficits in strength, balance, or coordination.
Ensure proper landing mechanics and deceleration control.
Phase 5: Return to Sport Phase (Weeks 12 and beyond)
Progress to advanced sport-specific training and drills.
Emphasize agility, speed, and power development.
Simulate game-like situations and sport-specific movements.
Evaluate functional performance and readiness for return to sport.
Ensure psychological readiness and confidence.
Provide ongoing monitoring and support during the transition back to competitive activities.
Remember, this is a general outline and should be tailored to the specific needs and progress of each patient. It is crucial to collaborate closely with the our team and individualize the rehabilitation program based on patient factors, graft choice, and surgeon preferences. Regular reassessment and communication with the patient are essential to ensure optimal outcomes.
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