Lateral / Posterolateral Corner Knee Reconstruction

Days 1–14

Exercises

• Dressing – POD 1: Debulk dressing, TED Hose in place
  • POD 2: Change dressing, keep wound covered, continue TED Hose
  • POD 7–10: Sutures out, D/C TED Hose when effusion resolved
• Brace – Locked in extension
• Crutches – Flat foot weight bearing (FFWB)
• Patellar mobilization (teach patient)
• AAROM, AROM 0–90 degrees
• Calf pumping
• Passive extension with heel on bolster or Prone hangs
• Electrical stimulation in full extension with quad sets and SLR
• Quad sets, Co-contractions quads / Hamstrings
• Straight leg raise (SLR) x 3 on mat, in brace (parallel bars if poor quad control)
  • NO ABD
• Ice pack with knee in full extension after exercise

Goals

• Pain / effusion control
• Good quad control

Weeks 2–4

Exercises

• Brace – locked in extension
• Crutches – Partial weight bearing (PWB)
• Continue appropriate previous exercises
• Scar massage when incision healed
• AAROM, AROM 0–90 degrees
• Begin Total Gym for ROM – Level 1–3
  • Passive flexion to 90 degrees (push up with opposite leg)
• Straight leg raise (SLR) x 3 on mat, no brace (no resistance) – NO ABD
• Double leg heel raises
• Stretches – Hamstring, hip flexors

Goals

• ROM 0–90
• No extensor lag

Weeks 4–6

Exercises

• Brace – Open to available range
• Crutches – Weight bearing as tolerated (WBAT) (D/C when gait is normal)
• Continue appropriate previous exercises
• AAROM, AROM 0–110 degrees
• Standing SLR x 4 with Theraband bilaterally (no brace)
  • May begin Hip ABD with Theraband if good LE control in full extension
• Mini squats in parallel bars – No knee flexion > 45 degrees
• Leg press with light resistance 0–45 degrees
• Hamstring curls 0–45 degrees – Carpet drags or rolling stool (closed chain)
• Proprioceptive ex – Single leg standing, double leg BAPS for weight shift
• Single leg heel raises
• Stationary bike for ROM – No resistance
• Pool therapy – Exercises in sagittal plane only

Goals

• ROM 0–110 degrees
• No effusion

Weeks 6–8

Exercises

• Brace – Open to full range
• Continue appropriate previous exercises
• PROM, AAROM, AROM to regain full motion
• Wall squats – No knee flexion past 45 degrees
• Forward, lateral and retro step downs
  • No knee flexion > 45 degrees (small step)
• Knee extension ex 90–30 degrees
• Hamstring curls 0–90 – Carpet drags or rolling stool (closed chain)
• Leg press 0–90 degrees with resistance as tolerated
• Hip weight machine x 4 bilaterally
• Proprioceptive ex – Progress to single leg BAPS, ball toss and body blade
• Stationary bike – Progressive resistance and endurance
• Elliptical trainer
• Treadmill – Forwards and backwards walking
• Pool therapy – Chest deep

Goals

• Full ROM

Weeks 8–12

Exercises

• D/C brace
• Continue appropriate previous exercises with progressive resistance
• Forward, lateral and retro step downs – Medium to large step
• Hamstring curl weight machine through full range
• Knee extension weight machine through full range
• Stairmaster – Small steps
• Treadmill – Walking progression program
• Pool therapy – Unrestricted
• ITB stretch

Goals

• Walk 2 miles at 15 min/mile pace

Months 3–4

Exercises

• Continue appropriate previous exercises
• Fitter
• Slide board
• Agility drills – Figure 8s, gentle loops, large zigzags
• Swimming
• Treadmill – Running progression program
• Quad stretches

Goals

• Run 2 miles at easy pace

Months 4–6

Exercises

• Continue appropriate previous exercises
• Agility drills / Plyometrics
• Sit-up progression
• Progressive weight training program
• Running progression to track
• Transition to home / gym program

Goals

• Return to all activities
• Pass a return-to-sport / fitness test at 6 months post-op
• No contact sports until 6 months post-op

Home exercise sheet · knee phase 1

Perform exercises below frequently: 30 reps 3–5x a day

• Quad Isometrics
• Heel Slides
• Active Assisted Motion
• Ice Position 15 minutes 2–3 x per day

Abbreviations

AROM / AAROM / PROM: active / active-assisted / passive range of motion. ROM: range of motion. ER / IR: external / internal rotation. ABD / ADD: abduction / adduction. FLEX / EXT: flexion / extension. WBAT / PWB / TTWB / NWB: weight bearing as tolerated / partial / toe-touch / non-weight bearing. SLR: straight leg raise. HS: hamstrings. ITB: iliotibial band. UE / LE: upper / lower extremity. UBE: upper body ergometer (arm bike). BAPS: balance board. BFR: blood flow restriction training. PREs: progressive resistance exercises. D/C: discontinue. prn: as needed. POD: post-operative day. TENS: transcutaneous electrical nerve stimulation. ADLs: activities of daily living.

Source

Adapted from William Beaumont Army Medical Center, Physical Therapy Section, "Lat PostLat Corner WB08", Revised August 2008, published by William Beaumont Army Medical Center (a work of the U.S. Government in the public domain). Original: Lat PostLat Corner WB08.pdf. Army-specific wording in the original (APFT) was replaced with civilian equivalents.

This protocol is general guidance for the rehabilitation team and does not replace the specific plan, restrictions and follow-up we set together. Your own situation may differ: if anything here does not match what we talked about, what we talked about wins, so please ask me.

Current version and every other protocol: aaronweymd.com/post-op-protocols