Complications are still possible but the focus at this stage of rehab after posterolateral surgery is turning to regaining range of motion.
First published 2009 by Dr Frank R Noyes, and reviewed August 2023 by Dr Sheila Strover (Clinical Editor)
Related course:Posterolateral corner injuries of the knee
Phase 3. Weeks 5-6 (Visits: 1-2)
Phase 3 of rehabilitation focuses on gaining fuller range of motion and keeping a close eye out for early complications.
| General observation |
Partial (25-50%) weight bearing when: - Pain controlled without narcotics - Hemarthrosis controlled - ROM 0-100° - Muscle control throughout ROM |
|
|---|---|---|
| Custom medial unloader brace or hinged soft tissue brace | ||
| Avoid hyperextension, varus loads | ||
| Evaluation | Goals | |
| Pain | Mild/No RSD | |
| Effusion | Minimal | |
| Patellar mobility | Good | |
| ROM minimum | 0-110 degrees | |
| Muscle control | 3/5 | |
| Inflammatory response | None | |
| Frequency | Duration | |
| Range of motion | ||
| 3x/day, 10 mins | ROM (passive, 0°-110°) | |
| Patella mobilization | ||
| Hamstring, gastroc-soleus stretches | 5 reps x 30 secs | |
| Strengthening | ||
| 2x/day, 20 mins | Straight leg raises (flexion: ankle weight, < 10% of body weight) | 3 sets x 10 reps |
| Isometric training: multi-angle (90°, 60°, 30°) | 2 sets x 10 reps | |
| Closed-chain | ||
| - Mini-squats | 3 sets x 20 reps | |
| Knee extension (active, 90°-30°) | 3 sets x 10 reps | |
| Aerobic conditioning (patellofemoral precautions) | ||
| 2x/day, 10 mins | UBC | |
| Stationary bicycling | ||
| Gait retraining (high risk for stretching reconstruction with resumption of weight bearing) | ||
| Muscle control quads & hams | ||
| Walk with toe-out gait, avoid toe-in varus position | ||
| Observe gait for any varus thrust or hyperextension | ||
| Smooth stance phase flexion pattern | ||
| Modalities | ||
| As required | electrical muscle stimulation | 20 minutes |
| cryotherapy | 20 minutes | |
| Goals | ROM 0°-110° | |
| Control inflammation, effusion | ||
| Muscle control | ||
| Early recognition complications (motion, RSD, patellofemoral) | ||
| 50% weight bearing |