Table 2 Rehabilitation program for ACLR and PCLR
Postoperative period | ACLR | PCLR | |
|---|---|---|---|
Early postoperative phase (0–6 weeks) | Joint mobility | 0–90° ROM exercise until 2 weeks 120° ROM increase until 6 weeks Manual patellar mobilization | Immediate immobilization in full extension with posterior pad Gradual increase to ROM 90° until 6 weeks Manual patellar mobilization |
Weight bearing and brace | Immediate full weight bearing with brace | Partial weight bearing with 0° locked brace | |
Exercise | Active quadriceps (straight leg raise, isometric quadriceps sets) Active hamstring exercise (hamstring sets, standing hamstring curls at 2 weeks) Ankle pump | Supine passive ROM with both hands support Prone passive flexion exercise Calf raise and isometric quadriceps sets | |
Functional goal | Normal gait pattern with single clutch and unlocked brace at 2 weeks Normal gait pattern without assistance and brace at 6 weeks | Early protected ROM Caution against posterior tibial translation by gravity, muscle action | |
Intermediate postoperative phase (6–12 weeks) | Joint mobility | Achieve more than 120° ROM | 90–120° ROM exercise until 12 weeks |
Weight bearing and brace | Brace off and start full weight bearing at postoperative 6 weeks | Start full weight bearing with brace at 6 weeks | |
Exercise | CKC exercise (squat 0–60°, lunge 0–60°, leg press with gradual progressive resistance), stationary bike, stairs (concentric and eccentric) | Continue ROM exercise Quad sets, single-leg squat, calf raise | |
Functional goal | Single-leg squat to 60°, equal quad girth | Normal gait pattern without assistance and brace at 12 weeks Increase ROM | |
Return to activity phase (12 weeks to 6 months) | Joint mobility | Full ROM | Achieve more than 120° ROM exercise |
Weight bearing & brace | Brace off and start full weight bearing at 12 weeks | ||
Exercise | OKC exercise Shuttle running, jumping rope, light running, aqua jogging | Hamstring strengthening exercise Start CKC exercise (mini-squat 0–45°, wall slides, leg press 0–45°) Progress CKC exercise Straight line running, swimming (no frog kick), jogging in pool | |
Criteria to progress to next phase | Single-leg full squat Single leg stance at least 60 s Good landing form with bilateral vertical and horizontal jumping | Full and pain-free ROM, normal gait, good to normal quadriceps strength, no patellofemoral complaints | |
Return to sports activity (after 6 months) | Exercise | Progressive running program, hop testing and training, progressive plyometrics, competitive sports, progress to sports-specific drills | Light sports, progress jogging and running Competitive sports after 9 months |