Associates in Orthopaedic Surgery, S.C.
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Michael H. Berkson, M.D.
Scott W. Mux. M.D.
Jeffrey A. Kazaglis, M.D.
Orthopaedics & Sports Medicine
PCL RECONSTRUCTION
Revised March 2007
Post-op Days 1-14
Dressing - POD 3 - 5: Change dressing, wound covered, continue TED Hose
-POD 7-10: Sutures out in Ortho
- Continue TED Hose on surgical leg until first Ortho follow-up
- D/C TED Hose on NON-surgical leg 3-5 days post-op
Brace - locked in extension x 6 weeks
Crutches - PWB in brace (D/C at 6 weeks)
Patellar mobilization (teach patient)
Calf pumping
Passive extension with heel on bolster or prone hangs
PROM flexion 0-60 degrees *NO ACTIVE HAMSTRINGS
Electrical stimulation in full extension with quad sets and SLR
Quad sets, Co-contractions quads/hams
SLR x 4 (parallel bars if poor quad control)
Weight shifts (supported in parallel bars)
Ice Pack with knee in full extension after exercise
Goals
Full passive extension
Good quad control
Weeks 2 - 4
NO HS Curls
Brace - locked in extension
x8Wks
Crutches - PWB (D/C at 6 weeks)
Continue appropriate previous exercises
AROM/AAROM - 0-60 degrees
PROM flexion 0-60 degrees progressing toward 90 degrees beginning Week 4
Scar massage when incision healed
SLR x 4 on mat - add light weight above knee if good quad control
Weight shifts (partial support in parallel bars)
Single leg heel raises in parallel bars
Stretches - HS, AT, Hip Flexors, ITB
Short arc quads - 0-45 degrees
Goals
ROM 0-60 degrees
No extensor lag
Weeks 4-6
Brace - locked in extension
Crutches - PWB
Continue appropriate previous exercises
AROM/AAROM - 0-90 degrees
Multi-angle Co-contractions at 0, 20, 40, 60 degrees
Standing SLR x 4 with Theraband above knee standing on NON-surgical leg
Pool therapy - walking in chest high water
Double leg mini squats (to 60 degrees)
Double leg calf raises
Goals
ROM 0-90 degrees
No effusion
Weeks 6 - 8
Brace - unlock to available motion (will continue brace 12 weeks per Ortho)
Crutches - WBAT (D/C when gait is WNL)
Continue appropriate previous exercises
AROM/AAROM - 0-90 degrees
SLR x 4 with light weight below the knee / sport cord
Double leg heel raises
Partial squats/wall slides to 45 degrees
BAPS in parallel bars
Ball Toss & Body Blade
Stationary bike for ROM -No resistance, Do NOT exceed 90 degrees knee flex.
Pool therapy - Waist deep
Cone walking
Goals
ROM 0-90 degrees
Normal gait
Weeks 8-12
Continue appropriate previous exercises with progressive resistance/reps
AROM/AAROM 0-110 degrees
Leg Press - 0-60 degrees - % body weight maximum
Hamstring curls - 0-60 degrees - % body wt maximum
Step-ups - lateral, forward, retro
Single leg heel raises
Continued on next page
Proprioceptive training - BAPS, Ball Toss, Body Blade
Parallel bar gait training without brace forward/backward/lateral
Stationary bike - ROM as tolerated - minimal resistance
Treadmill - Backwards and forwards walking
Pool therapy - unrestricted
Stairmaster
Goals
ROM 0-110 degrees
Walk 2 miles at 20 min/mile pace
Months 3 - 4
Functional brace per surgeon
Continue appropriate previous exercises with progressive resistance
Full AROM/AAROM
May begin incorporating open chain strengthening as tolerated
Leg press and HS curls thru full range with lowweight and high reps
Functional exercises - Fitter, slide board
Carioca with brace in parallel bars
Treadmill - Forwards walking approaching 15 min/mile pace
Pool - Begin swimming laps
Goals
Full ROM
Walk 2 miles at 15 min/mile pace
Months 4-6
Home/gym program
Continue strengthening, stretching, closed chain, proprioceptive training
Agility drills / Plyometrics
Quad stretches
Sit-up progression
Treadmill - Running progression program
Functional test at 6 months to clear for sports and discharge
- Must have 90% of opposite leg
Goal - Jog 2 miles in 20 minutes
Months 6-9
Continue appropriate previous exercises with progressive resistance
Treadmill or Track - Run at own pace/distance
Goals
Return to all activities
Pass APFT at 9 months post-op
No contact sports until 9 months post-op
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