Week 1 – 2

  • Pain and swelling management with regular ice packs
  • The patient will notice a bulky bandage that can come off in 48 hours
  • There will be multiple small surgical scars that need to be kept covered with small sticky dressings.
  • Ice the back of thigh due to hamstring harvest
  • Early Weight bearing Mobilisation with crutches for support
  • Knee Extension splint or locked knee brace for first 2 weeks

Week 2 – 6

  • Wean off brace but keep crutches for balance
  • Achieve 90 degrees of flexion by 4 weeks and full flexion by 6 weeks
  • Closed chain quadriceps rehabilitation
  • Maintain balance and provide gait training
  • Let the knee hang at edge of chair and perform heel slides
  • Avoid manual patella mobilisation
  • Start mini squats and proprioceptive exercises

Week 6 – 12

  • Continue closed chain exercises
  • Commence bike work
  • Resistance exercises on bike and with therabands
  • Hamstring stretches
  • Core strengthening
  • Proprioceptive exercises
  • Increase quadriceps strengthening programme

Week 12 onwards

  • Start more dynamic exercises and strength training
  • Start light running
  • Delay impact training if there is significant chondral pathology
  • Initiate plyometrics
  • Progression to cutting motion and any sports specific rehabilitation depends on individual patient response and needs