Protection of the ligament repair is essential. Begin active knee flexion at 6 weeks for ACL/PCL and/or MCL an at 8 weeks for PLC reconstruction. Rehab Protocols and Patient Forms This website is provided by the American Academy of Orthopaedic Surgeons as a service to its members. Dr. Rolf . Sports Medicine Rehabilitation Protocols. Rx. Considerations for the Post … Pre-operatively on the ward • Discuss post -operative rehab ’ Kevin Wilk, DPT, Mike Reinold DPT, SCS, CSCS, and James Andrews, MD have created some of the most widely used, published, cited, and respected rehabilitation protocols based on exactly how they progress their patients. Patient will wear immobilizer for 2 weeks following injury, except in P.T. Medial Collateral Ligament (MCL) Rehabilitation Protocol Weeks post-injury 1-2 Weeks Initiate physical therapy. Specific time frames, restrictions and precautions may also be given to enhance wound healing and to protect the surgical repair/ reconstruction. You may vary in your ability to do these exercises and to progress from one phase to the other. Rx: ACL Post-Op Rehab – Phase 1 (follow my protocol strictly) Dressing change / wound check 2-3 days post-op Call my office if patient unable to get 0 – 90o ROM by 2 weeks post-op Emphasize early full passive extension to 0o Precautions: X Per my PT protocol Other: Protect MCL repair – no valgus or ER stress The following schedule serves as guidelines to help in the expediency of returning a patient to his or her pre-injury state. The general goal is to have an athlete or patient return to full activities . They are cause by either a direct blow (more severe tear) or a non-contact injury (less severe). It is by no means intended to be a substitute for one’s clinical decision-making regarding the progression of a … Restrictions: No heavy lifting greater than 0 lbs. Start each exercise slowly. Metacarpal Fracture Reduction and Pinning !erapy Instructions Laith Al-Shihabi, MD 0-2 weeks Patients are treated with a home motion program for the !rst 2 weeks while a … Commonly associated injuries include posterolateral corner cruciate ligament tears as well as meniscal pathology. Medial Collateral Ligament and MPFL Repair Rehabilitation Protocol . Rehabilitation Protocol for Meniscus Repair This protocol is intended to guide clinicians and patients through the post-operative course for a meniscus repair. MCL rehab time refers to the time it takes for a person to complete a full MCL rehabilitation program. To serve as a guide to physical therapy following your surgery, this section contains rehabilitation protocols specific to your procedure. The most treatment protocols focusing on early range of motion, reducing swelling, protected weight bearing, progression toward strengthening and stability exercises. If your clinic does not have isokinetic equipment, please schedule test with Ohio State at 4 months post op. Please fax initial evaluation and progress notes to 815‐381‐7498. Leg press to 60 degrees. Please call your doctor if you are having a problem with your knee or if you need clarification of these instructions. These protocols are meant to provide general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Contact Ohio State Sports Medicine at 614-293-2385 if questions arise. The overall rehabilitation principles are: To control edema; To initiate M. Quadriceps activation in the initial hours to days after injury. (ACL-R AND MCL REPAIR) CLINICAL PRACTICE GUIDELINE Progression is time and criterion-based, dependent on soft tissue healing, patient demographics and clinician evaluation. T he medial … Grade 1 Rehab: MCL rehab can begin immediately following the injury and should be focused on proper mobility and recovering full range of motion in about a 2-4 weeks window. REHABILITATION OF ISOLATED MCL SPRAINS This program may be accelerated for Grade I MCL Sprains or may be extended depending on the severity of the injury. Rehabilitation Guidelines for Meniscal Repair (Inside Out) The intent of this protocol is to provide the clinician with a general guideline of the post-operative course of the patient that has undergone the above stated procedure. of modalities for pain and swelling as needed. All materials on this Web site have been created, developed or assembled by the member physician, who is solely responsible for its content and any permissions necessary to properly place the materials on this website. September 27, 2014 by Alicia Rayner. Since you mentioned you had a meniscus repair in addition to an ACL reconstruction, your surgeon will have a specific protocol he or she wants you to follow that gradually increases your knee flexion, so as to protect the meniscus as it heals. Over a 5-year period, 9 patients sustained this complication. Medial Collateral Ligament Sprain: Rehab Exercises. An average MCL rehab program is going to vary depending on the type of sprain. Elbow Trauma Rehabilitation Protocol Includes post ORIF, or conservatively managed trauma when active ROM indicated N.B. Please note these are meant to be guidelines for rehabilitation to be followed by a certified physical or occupational therapist. For terrible triads, or ORIF + ligament reconstruction, please also refer to ligament repair protocols. However, individual patients will progress at different rates depending on their age, associated injuries, pre-injury health status, rehab compliance, tissue quality and injury severity. How to do the exercises. It is by no means intended to substitute for one's clinical decision making regarding the progression of a patient's post- operative course based … Medial collateral ligament injuries occur following a traumatic valgus force, often while the knee is slightly flexed. Rehabilitation Protocol for Arthroscopic Meniscal Debridement . This protocol varies, however, so I would ask your surgeon for specific instructions to follow that is tailored … You will be told when to start these exercises and which ones will work best for you. Grade 2 Rehab: MCL rehab … One could work on motion, decreased swelling, and making sure that one’s muscles start to recover immediately. treated successfully by nonoperative functional reha-bilitation protocols. A recent review of the literature by DeLong and Waterman11 described numerous variations in MCL reconstruction tech-niques, with a lack of … Isolated MCL Repair / Reconstruction Postoperative Rehabilitation Protocol Dr. Jeffrey Witty, M.D. ANTERIOR CRUCIATE LIGAMENT (ACL) WITH MENISCUS REPAIR POST-OP REHABILITATION PROTOCOL The following is a protocol for postoperative patients following ACL reconstruction and meniscus repair (medial or lateral). Accepted surgical techniques for treatment of MCL injuries include various reconstruc-tion techniques, such as that described in this report, and direct ligament repair. Rehabilitation Protocols. The intent is to provide the therapist with a … rehabilitation. MCL Rehabilitation- From Ruin to Return to Play. Begin the following at 6 weeks for ACL/PCL and/or MCL and at 8 weeks for PLC recon. No valgus stress or open chain for … The exercises may be suggested for a condition or for rehabilitation. Contact Information. Lateral Collateral Ligament Reconstruction Rehab Protocol The lateral collateral ligament, or LCL is probably the least often injured ligament of the knee. Meniscal Repair Postoperative Protocol Information on postoperative rehabilitation following meniscal repair. Rehab Protocols. Introduction. Rehabilitation … Complete MCL tears should probably always be treated with a brace to prevent them from healing in a looser position, whereas physical therapy for most MCL tears can be started immediately … 1‐14 Days Postoperative Do NOT remove the surgical bandage. If you have questions, contact the referring physician. Associate Professor of Orthopaedics Chief - Division of Sports Medicine Tel: (212) 598-6784 Rehabilitation Protocol: ACL, MCL and PCL Reconstruction Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. primary MCL repair with internal bracing with 2 limited incisions. This protocol is a guideline for your rehabilitation after posterior cruciate ligament reconstruction. Stationary bike (low resistance, high seat, with NO toe clips – so as to prevent hamstring contraction) Mini-squats to 45 degrees. Department of Rehabilitation Services Physical Therapy PCL Reconstruction Protocol The intent of this protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone a PCL or PCL/ACL reconstruction. Associate Professor of Orthopaedics Chief - Division of Sports Medicine Tel: (212) 598-6784 Rehabilitation Protocol: ACL and M CL Reconstruction 12 With an augmented repair, patients may be immediately weight-bearing and start range-of-motion exercises under the supervision of a therapist within the first week of surgery. Medial collateral ligament Injury of the knee (MCL Tear) are the most common ligament injuries of the knee and are frequently associated with ACL tears. Rehabilitation Protocols by Wilk, Reinold, and Andrews . meniscus repair) - AVOID valgus force to knee during rehab exercise - No aggressive PROM to avoid stretching graft tissue - PT to educate and observe patient to avoid … These are some of the same protocols that have been published in journals such as: We've recently … Notes: - Please review any additional notes for adjustments to protocol depending on concurrent pathology (ex. We reviewed their sub- PHASE I: 0 – 2 weeks after surgery You will go home with a … One should start rehabilitation for MCL tears as soon as the injury is identified. Naval Medical Center San Diego, Department of Orthopaedic Surgery 34800 Bob Wilson Drive, Suite 112 Building 1, 1st Floor San Diego, CA USA 92134 View map Phone 619 … With this technique, early surgical intervention is possible, and early rehabilitation is safe because of the internal bracing. Advantages include fast recovery, avoidance of muscle atrophy because of early mobilization, prevention of residual valgus instability, and maintenance of proprioception. who sustained an intraoperative MCL injury during a primary total knee arthroplasty and were treated by direct primary repair and no change in implant constraint or post-operative protocol. No driving. The primary goal of this protocol is to protect the reconstruction and while steadily progressing towards and ultimately achieving pre-injury level … Here are some examples of exercises for you to try. Non-Operative MCL Tear Rehabilitation Protocol The intent of this protocol is to provide the clinician with a guideline for a non-operative rehabilitation course of a patient with an isolated medial cruciate ligament injury. Elbow Lateral Collateral Ligament (LUCL) Repair Rehabilitation Protocol Kelly Holtkamp, M.D. To … However uncommon, it does occasional tear, not usually in isolation. Postoperatively, I treat the patients with combined ACL and MCL injuries with reconstruction/repair in a hinged knee brace for approximately 3 to 4 weeks. Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. Knee … Easy stationary bike for range of motion (ROM's), Quads, straight leg raises (SLR's), calf raises. Treatment is usually bracing unless there is gross varus instability in which case repair or reconstruction is performed. Gentle ROM's. For example, a typical MCL repair protocol may involve non–weight-bearing for 3 weeks, with progression to weight-bearing as tolerated within 6 weeks, while limiting range of motion. Please note that if there is any increase in pain or swelling or loss of range of motion these serve as … General Guidelines: Immediate Post-op • No passive extension or passive flexion exercises • Gentle AROM or AAROM knee flexion is permitted within MD limitations (usually 90 degree limit for the first 6 weeks and then slow ROM progression as the capsular structures allow- use pain as a guide) • … Ease off the exercises if you start to have pain.
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