SportsMed Orthopaedic Group, Inc.
SportsMed Orthopaedic Group, Inc.
SportsMed Orthopaedic Group, Inc.

Knee Protocols

Below are some guidelines and protocols that most patients can follow. Each patient may have a slightly different program tailored to their age and the level of repair that was done. You should always start out gradually and work your way up to heavier weights or longer activities. Stretching should be done routinely as directed by your physician or therapist, and warm-up exercises are advised before more vigorous activities. If you have specific questions about resuming an activity or sport that is not addressed below, please ask your doctor first.

Meniscal tear debridement (Partial meniscectomy)

Brace:
No brace will be needed for this surgery. An ace wrap or the compression stocking will provide comfort and help to decrease swelling if worn over the first week or two.

Range of Motion:
Weeks 1-6 emphasize knee flexion and extension exercises. These should be performed twice a day until full motion has returned and then 3x/week for maintenance.

Strengthening:
Start in second week after surgery. Begin with distance walking and riding a stationary bicycle. By the fourth week, you should progress to formal strengthening of thigh and leg muscles as comfort permits. Continue until full strength and function have returned. Perform these exercises at least 4x/week for 30 minutes/day. Return to Sport: Patients may return to regular activities when their swelling has resolved and strength and motion are at least 90% of the normal leg. Swimming and bicycling can be started in the second week after surgery

Return to Work:
Patients with low demand jobs often return to work the week of surgery. Patients who have higher demand jobs which involve heavy lifting or walking will return to work when they feel comfortable and secure, usually within the first six weeks.

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Articular Cartilage Debridement

Brace:
No brace will be needed for this surgery. An ace wrap or the compression stocking will provide comfort and help to decrease swelling if worn over the first week or two.

Range of Motion:
Weeks 1-6 emphasize knee flexion and extension exercises. These should be performed twice a day until full motion has returned and then 3x/week for maintenance.

Strengthening:
Start in second week after surgery. Begin with swimming, gentle walking, and riding a stationary bicycle. By the fourth week, you should progress to formal strengthening of thigh and leg muscles as comfort permits. Continue until full strength and function have returned. Perform these exercises at least 4x/week for 30 minutes/day. Return to Sport: Patients may return to most regular activities after the first month when their swelling has resolved and strength and motion are at least 90% of the normal leg. Swimming and bicycling can be started in the second week after surgery. Impact and cutting activities that involve running, jumping, or twisting the knee should be avoided for the first eight weeks.

Return to Work:
Patients with low demand jobs often return to work the week of surgery. Patients who have higher demand jobs that involve heavy lifting or walking will return to work when they feel comfortable and secure, usually within the first eight weeks.

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Meniscal Repair or Transplant

Brace:
No brace is usually needed for this surgery. An ace wrap or the compression stocking will provide comfort and help to decrease swelling and should be worn for the first two weeks.

Range of Motion:
Weeks 1-6 emphasize knee extension exercises. Flexion is limited to ninety degrees for the first six weeks to allow healing of the meniscus without too much stress. These exercises should be performed twice a day until full motion has returned and then 3x/week for maintenance.

Strengthening:
Start with straight leg raises and quadriceps isometrics the week after surgery. Begin with swimming and distance walking at week four and riding a stationary bicycle at week six. Formal strengthening of thigh and leg muscles can be initiated around week eight. Continue until full strength and function have returned. Perform these exercises at least 4x/week for 30 minutes/day.

Return to Sport:
Swimming can be started in the fourth week after surgery, and stationary bicycling can be started at week six. In-line running can be resumed at a gentle pace around the fourth month. Impact and cutting activities that involve running, jumping, or twisting the knee should be avoided for the first six months.

Return to Work:
Patients with low demand jobs often return to work after a few weeks. Patients who have higher demand jobs that involve heavy lifting or walking long distances will return to work around the third month.

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ACL (Anterior Cruciate Ligament) Reconstruction

Brace:
No brace is usually needed for this surgery. If you have multiple ligaments injuries or a particularly unstable knee, a brace may be used. An ace wrap or the compression stocking will provide comfort and help to decrease swelling and should be worn for the first two weeks.

Range of Motion:
Weeks 1-6 emphasize knee flexion and extension exercises. These should be performed 2x/day every day until full motion has returned and then 3x/week for maintenance.

Strengthening:
Begin with straight leg raises and quadriceps isometrics the week after surgery. After four weeks, you may start swimming, distance walking, and riding a stationary bicycle. Formal strengthening of thigh and leg muscles can be initiated after six weeks as comfort permits. Continue until full strength and function have returned. Perform at least 4x/week for 30 minutes/day.

Return to Sport:
Swimming and stationary bicycling can be started one month after surgery. In-line running can be resumed at a gentle pace around the fourth month. Impact and cutting activities that involve running, jumping, or twisting the knee should be avoided for the first six months.

Return to Work:
Patients with low demand jobs often return to work the week of surgery. Patients who have higher demand jobs which involve heavy lifting or walking will return to work when they feel comfortable and secure, usually within the first eight weeks.

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Partial or Total Knee Replacement

Brace:
No brace is needed for this surgery. An ace wrap or the compression stocking will provide comfort and help to decrease swelling and should be worn for the first two weeks.

Range of Motion:
Weeks 1-12 emphasize knee flexion and extension exercises. Perform these exercises 3x/day every day for twenty minutes a session until full motion has returned. After full motion has been obtained, these exercises should be done 3x/week for maintenance.

Strengthening:
By the second week after surgery you should perform isometrics, straight leg raises, and walking. At four weeks start swimming and riding a stationary bicycle. Formal strengthening of thigh and leg muscles can begin at week four. Continue until full strength and function have returned. Perform these exercises at least 4x/week for 30 minutes/day.

Return to Sport:
Swimming and stationary bicycling can be started in the fourth week after surgery. Return to regular activities can occur when you have good range of motion and strength is approximately 90% of the other knee. Heavy impact sports should be minimized to prolong the life of your implant.

Return to Work:
Patients with low demand jobs often return to work the month after surgery. Patients who have higher demand jobs that involve heavy lifting or walking will return to work when they feel comfortable and secure, usually after three months.

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