physiotherapist doctor rehabilitation consulting physiotherapy giving exercising leg treatment with patient in physio clinic or hospital


1st Week After Surgery:

  • Keep surgical dressing in place until follow up appointment and do not get wet
  • Elevate operative extremity above the level of the heart as often as possible
  • Apply ice to the operative knee for 20 minutes at a time at least five times a day
  • Begin CPM machine the day after surgery
  • Brace locked in extension at all times except when using CPM machine
  • DVT prevention:
    • 1 tablet 325 mg aspirin per day (obtain over the counter)

Phase I

0 to 6 Weeks

Main goals:

  1. Graft incorporation into native bone
  2. Early range of motion


  • Weightbearing – heal touch
  • Brace
    • Weeks 0 – 2
      • Worn in extension at all times except during strengthening exercises or CPM use
    • Weeks 2 – 6
      • Worn at all times but allow full flexion and extension
  • Continuous Passive Motion (CPM) Machine
    • Use 6 hours per day
    • Start at 0° to 40° 
    • Increase 5° to 10° per day
    • Goal on CPM is to be at 100° by Week 6


  • Passive and active range of motion exercises as tolerated at 2 weeks post op
  • Emphasis on strengthening and mobilization

Phase II

6 to 8 Weeks

Main Goals:

  1. Progress to full weightbearing
  2. Obtain full range of motion


  • Initiated at 25% of weight
  • Advance by 25% each week to full weightbearing

Range of Motion:

  • Increased daily to goal of 130° of flexion


  • Improve strength, flexibility, and neuromuscular control
  • Initiate cardio

Phase III

8 – 12 Weeks

Main goals:

  1. Restore flexibility, strength, flexibility, and neuromuscular control
  2. Full pain-free range of motion


  • Initiate gate training
  • Closed chain exercises
  • Initiate unilateral stance exercises

Phase IV

12 Weeks to 6 Months

Main Goals:

  1. Full, pain-free range of motion 
  2. Normal gait with full weightbearing


  • Advance strength training as tolerated
  • Advance to single-leg curls and extensions by 14 to 16 weeks

Phase V

6 to 12 Months

Main Goals:

  • Regain high levels of proprioception, strength, neuromuscular control, and flexibility


  • Sport-specific training

Return to Play:

  • Typically 6 – 8 months after surgery
  • General criteria:
    1. Full active range of motion without apprehension
    2. Operative extremity within 10% of contralateral extremity on isokinetic testing

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