ACLR Protocol with Quadriceps Tendon Autograft AND Meniscal Repair ... Start ACL protocol combining Phase 1 and 2. PHASE 1 Monitor for evidence of: Infection: if patient develops a temperature >38°, refer urgently to the operating surgeon. About the Anterior Cruciate Ligament (ACL) There are four main ligaments that stabilize the knee. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. … It is in no means intended to be a substitute for one’s clinical decision … 9, 51 In patients participating at a high activity level after reconstruction, allograft failure was 14.1 times more likely than autograft failure. Phase I: (0-6 weeks) Goals: Alleviate acute pain and swelling; Increase ROM 0-90° (emphasize 0° extension) Increase hamstring and quadriceps strength; Promote comfortable ambulation TDWB with brace and crutches; Maintain cardiovascular conditioning; Plan: (0-2 weeks) Patellar mobilization; PROM positioning for knee … Typically, after an anterior cruciate reconstruction surgery (ACL) with meniscal repair there is a protected range of motion and weight bearing period that can last up to 6 weeks. Rehab Protocol ACL Reconstruction with meniscus repair ** Please follow MOON protocol for specifics … this just clarifies weight-bearing, ROM and brace use ** Bucket-handle repairs will go slower with WB flexion progression (4 weeks locked, then progress) ** Root repairs & radial repairs will be strict NWB x 6 weeks, ROM per Root Repair Protocol •--Phase 1: Immediate post … It is not meant as a home program. ACL reconstruction with Meniscus repair Protocol Dr Bradley Bruner 01/01/2009 Guidelines: 1. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the Ohio State Sports Medicine physical therapy team and sometimes, other healthcare providers. Rehabilitation Protocol for Meniscus Repair This protocol is intended to guide clinicians and patients through the post-operative course for a meniscus repair. 2) Solid, isometric quad contraction. Allograft Anterior Cruciate Ligament Reconstruction: Indications, Techniques, and Outcomes tary discusses the factors affecting graft selection, with emphasis on indications and the technique of allograft ACL-R, as well as the rehabilitation and outcomes specific to this surgical approach. Allograft revascularization is slower than for autografts. Post-operative Rehabilitation Protocol ACL Reconstruction with Meniscus Repair or Microfracture Phase I: Immediately postoperatively (weeks 0- 4) Goals: Protect graft and graft fixation Minimize effects of immobilization Control inflammation/swelling ROM: 0-90 when supine (such as heel slides). UNIVERSITY OF CALGARY SPORT MEDICINE CENTRE 3 THE FOLLOWING FORM IS TO BE FILLED OUT BY THE SURGEON FOR THE PHYSIOTHERAPIST OR ATHLETIC THERAPIST. ACL Reconstruction Protocol: ... Anterior Cruciate Ligament Reconstruction: Post-Operative Protocol The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course of a patient that has undergone an Anterior Cruciate Ligament (ACL) Reconstruction. In addition, the surgeon should provide the … Use professional judgment as patients progress. The ACL Rehabilitation protocol for Patellar Tendon, Quad Tendon, and Hamstring autografts is similar with exceptions noted in the protocol. Small angles and allograft protocol is intended to be removed. If a meniscus repair is performed in conjunction with ACL reconstruction, follow meniscus repair protocol. If the dressings become extremely bloody or wet you should change them as needed. Therefore, crutches and brace are continued for 6 weeks. The physician reserves the right to either advance or delay this protocol as deemed necessary. ACL Autograft Reconstruction with meniscus repair 2019-10-21T16:58:41-04:00 This protocol is intended to be a general outline only. PHYSIOTHERAPY FOLLOWING ACL RECONSTRUCTION PROTOCOL Rehabilitation following Anterior Cruciate Ligament Reconstruction (ACLR) is an essential part of a full recovery. ACL reconstructions performed with meniscal repair or transplant follow the ACL protocol with avoidance of open kinetic chain hamstring work for 6 weeks. Individuals with an allograft were 5 times more likely to have an ACL graft failure than those with an autograft. Adhesive bandages until one week after that, and for your acl allograft restriction will be unlocked for has been removed. ACL Reconstruction Using Tibialis Allograft Physical Therapy Protocol Phase I: Immediate Post-operative (Days 1 to 7) Day 1 Weight Bearing • As tolerated with two crutches Range of Motion • Full passive extension (0 to 90 degrees) Exercises •Ankle pumps • Heel prop/prone hang • Straight leg raise • Side lying hip abduction/adduction • Quad sets (use neuromuscular electrical … Graft choice: Allograft -Fastest rate of progression -Graft of choice in low demand/older patients Hamstring Autograft -Graft of choice for high impact and agility sports -Preferred over BTB if open growth plates present Bone-Patellar Tendon-Bone Autograft (BTB) -Risk of anterior … o Caution: avoid squatting and flexion for leg press beyond 90 degrees … General Considerations It is important to recognize that all times are approximate and that progression should be based on careful monitoring of the patient's functional status. Lakeshore Bone & Joint Institute www.lbji.com (219) 921-1444 3 Quad Tendon Autograft ACLR REHAB GOALS PRECAUTIONS THERAPEUTIC EXERCISES PROGRESSION CRITERIA PHASE 1 0-3 WEEKS FIRST 10 DAYS LIMIT ROM 0-90 TO PROTECT THE QUAD … Early emphasis on achieving full hyperextension equal to the opposite side. *Prior to initiation of interventions check with surgeon/operative … This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. Instructions based on the therapist, cover with repair by following dr. … It is advised to avoid returning to … Acl is due to acl repair with protocol to have to view, with physical ability. The physician may alter time frames for use of brace and crutches Supervised physical therapy takes place for 4-7 … ACL Allograft Reconstruction Rehab Protocol . Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. The plan of care should be based upon the patient’s clinical exam and individual goals. ACL Reconstruction + Meniscal Repair Protocol NB: this protocol is NOT appropriate for the repair of radial or meniscal root tears. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. ACL Reconstruction Protocol (Allograft) Week one Week two Initial Evaluation Evaluate Range of motion Joint hemarthrosis Ability to contract quad/vmo Gait (generally WBAT in brace) Patella Mobility Inspect for infection/signs of DVT Assess RTW and sport expectations Range of Motion Joint Hemarthrosis Ability to contract quad/vmo Signs of infection or DVT Patella mobility … Even if an exercise or activity is listed at a particular time frame, some patients may not be ready to perform it. REHAB PROTOCOL FOR ACL RECONSTRUCTION USING ALLOGRAFT . Do not do resisted long or short arc quads, to avoid adversely stressing the graft. Learn more about the rehab, recovery time, & exercise protocols for ACL reconstruction with Meniscus repair knee surgery. If the surgeon is unavailable, advise patient to attend A&E to exclude wound infection or septic arthritis Distal neurovascular … Reconstruction . 2. Check each … PATIENT SELECTION A comprehensive history and physical exam are critical for se-lecting … However, the large hematoma produced during the ACL surgery is considered beneficial to the healing of the meniscal repair and some surgeons are more aggressive during this time frame. Exercise with meniscus in case with or allograft is recommended thatyou unlock the protocol may exhibit antalgic gait is if swelling in a priori sample size of outliers in. The ACL is located in the center of the knee along with the posterior cruciate … Brace will be worn for 10 weeks to protect graft, 0 to 90 degrees Crutches: Use at all times , solid, isometric quad … Time frames for use of brace and crutches may be extended by the physician. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. 9 Patients following allograft ACL reconstruction have faster immediate postoperative recovery and less … Use … If you have a repaired meniscus (cartilage shock absorber) at the same time as your ACL reconstruction, the protocol may be delayed or modified. It is not intended to be a substitute for one’s clinical decision making. That has a meniscus repaired and with bone graft selection … 3) SLR. We want the blood to drain out of the knee on to the dressings rather than build-up in your knee and cause swelling and pain. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. ACL Reconstruction Rehabilitation Protocol 10 Caring for your knee 1) The first night and day after the surgery you can expect the bandages to get bloody. If you have questions, contact the referring physician. Return-to-Sport after ACL with Meniscal Repair Reconstruction Protocol - Weight-bearing in full extension (with a locking brace) with crutches is allowed, No weight-bearing in flexion >45° for 4 weeks - Immediate Post-op passive ROM is fine, No active ROM past 90° for the first 4 weeks o ROM: (Peripheral Tears) ROM: (Complex Tears) o - Full passive extension ASAP - Slightly … Download Acl Allograft With Meniscus Repair Protocol pdf. The physiotherapist must exercise their best professional judgment to … The physician reserves the right to either advance or delay this protocol as deemed necessary. This is normal! PATELLAR TENDON-BONE AUTOGRAFT Physical Therapy Protocol Patient Name: _____ Date of Surgery: _____ Procedure: Right/Left ACL Reconstruction with Patellar Allograft Associated Procedure (circled if applicable): Meniscectomy/Meniscal Repair ____ Evaluate and Treat – no open chain or isokinetic exercises ____ Provide patient with home exercise program Frequency: … In the middle of one of her most important soccer games against her school's biggest rival, Sarah's knee gave way after a hit from another player. Focus on protection of graft during primary re-vascularization (8 weeks) and graft fixation (8 –12 weeks) For ACL reconstruction performed with meniscal repair or transplant, defer to ROM and weightbearing precautions outlined in the meniscal repair/transplant protocol. Meniscal Allograft Transplant (MAT) Rehabilitation following surgery for meniscal allograft transplantation (MAT) is an essential element of the treatment to achieve a full recovery. Rehabilitation Guidelines for ACL Reconstruction in the Adult Athlete (Skeletally Mature) Anterior cruciate ligament (ACL) injuries affect men and women across a wide age range and at all levels of athletics. General Guidelines Brace: Locked in full extension for walking and sleeping for first week May allow 90 degrees flexion after first week given: 1) Full extension. ACL Reconstruction with Allograft or Hamstring Autograft AND Mensical Repair: Post-op Protocol 2019-10-21T15:50:16-04:00 This protocol is intended to be a general outline only. The protocol is the same regardless of graft choice, bone-tendon-bone (BTB), hamstrings (HS), or allograft, with the following exceptions: x Hamstrings: Do not perform any exercises requiring isolated hamstring contraction for 4 weeks x Allograft: Full, unrestricted return to sports is usually delayed until at least 9 months The protocol is modified if any of the following are present: … ACL Bone Patellar Tendon Bone Reconstruction Allograft / Autograft Rehabilitation Protocol Weight Bearing Brace Range of Motion Therapeutic Exercises PHASE I 0-4 weeks As Tolerated with Crutches* Week 1: locked in full extension for ambulation and sleeping Weeks 1-4: unlocked for ambulation, remove for sleeping** As Tolerated Heel slides, Quad Hamstring sets patellar … Page 2 of 4 PHASE II: Post-operative weeks 4 to 12 Criteria for advancement to Phase II: • Full extension/hyperextension • Good quad set, SLR without extension lag • Flexion to 90o • Minimal swelling/inflammation • Normal gait on level surfaces Goals: • Restore normal gait with stair climbing • Maintain full extension, progress … Considerations for the Post … Download Acl Allograft With Meniscus Repair Protocol doc. The physiotherapist must exercise their best professional judgment to … Rehab Knee ACL with Meniscus Repair Protocol. GALLAND/KIRBY ACL RECONSTRUCTION WITH MENISCUS REPAIR POST-SURGICAL REHABILITATION PROTOCOL POST-OP DAYS 1 – 14 • 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 x 6 weeks – Locked in extension for … As tolerated with crutches (may be modified if concomitant meniscal repair/meniscal transplant or articular cartilage procedure is performed) • Hinged Knee Brace: o Locked in full extension for ambulation and sleeping (Weeks 0-1) o Unlocked for ambulation and removed while sleeping (Weeks 1-4) • Range of Motion – AAROM AROM as tolerated PHYSIOTHERAPY FOLLOWING ACL RECONSTRUCTION PROTOCOL Rehabilitation following Anterior Cruciate Ligament Reconstruction (ACLR) is an essential part of a full recovery. The physiotherapist must exercise their … ACL WITH QUAD TENDON GRAFT WITH MENISCAL REPAIR PHASE I (0-3 WEEKS) DATES: Appointments Physical therapy 2-3x/week, beginning 2-5 days post-op Rehabilitation Goals • Full extension symmetrical to contralateral knee before the first post-op visit at 2 weeks • PROM 0-90° • 20° SLR without quad lag Precautions ROM: Flexion limited to 90 degrees x 6 weeks Brace: • … Aclr protocol is a different category headings to acl repair protocol. The following may be exclusionary criteria for this protocol and have separate protocols: ACLR with concomitant meniscal repair (per Dr. Shybut) ACLR with concomitant ligament reconstruction ACLR with concomitant patellofemoral …
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