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Table 2 Rehabilitation program for ACLR and PCLR

From: Changes in hamstring strength after anterior cruciate ligament reconstruction with hamstring autograft and posterior cruciate ligament reconstruction with tibialis allograft

Postoperative period ACLRPCLR
Early postoperative phase (0–6 weeks)Joint mobility0–90° 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 braceImmediate full weight bearing with bracePartial weight bearing with 0° locked brace
ExerciseActive 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 goalNormal 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 mobilityAchieve more than 120° ROM90–120° ROM exercise until 12 weeks
Weight bearing and braceBrace off and start full weight bearing at postoperative 6 weeksStart full weight bearing with brace at 6 weeks
ExerciseCKC 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 goalSingle-leg squat to 60°, equal quad girthNormal gait pattern without assistance and brace at 12 weeks
Increase ROM
Return to activity phase (12 weeks to 6 months)Joint mobilityFull ROMAchieve more than 120° ROM exercise
Weight bearing & brace Brace off and start full weight bearing at 12 weeks
ExerciseOKC 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 phaseSingle-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)ExerciseProgressive running program, hop testing and training, progressive plyometrics, competitive sports, progress to sports-specific drillsLight sports, progress jogging and running
Competitive sports after 9 months
  1. ACLR anterior cruciate ligament reconstruction, CKC closed kinetic chain, OKC open kinetic chain, PCLR posterior cruciate ligament reconstruction, ROM range of motion