At this stage of rehabilitation after posterolateral corner surgery the focus is upon gait, strength and endurance.
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 5 of knee rehabilitation focuses on improving gait, and building up strength and endurance.
Below I have given you an overview of our own rehabilitation protocol for this phase, and on the right you will be able to click through to the detailed protocols for each phase.
Phase 5. Weeks 9-10 (Visits: 1-2)
| General observation |
Full weight bearing (wk 12) when: - Pain, effusion controlled - Muscle control throughout ROM |
|
|---|---|---|
| ROM 0°-135° | ||
| Custom medial unloader brace or hinged soft tissue brace | ||
| Evaluation | Goals | |
| Pain | Minimal/No RSD | |
| Manual muscle test | 4/5 | |
| - Hamstrings, quadriceps, hip abductors/adductors/flexors/extensors | ||
| Swelling | Minimal | |
| Patellar mobility | Good | |
| Crepitus | None/slight | |
| Gait | Symmetrical | |
| Frequency | Range of Motion | Duration |
| 2x/day, 10 mins | Hamstring, gastroc-soleus, quad, ITB stretches | 5 reps x 30 secs |
| Strengthening | ||
| 2x/day, 20 mins | Straight leg raises | 3 sets x 10 reps |
| Straight leg raises, rubber tubing | 3 sets x 30 reps | |
| Hamstring curls (week 12, active, 0°-90°) | 3 sets x 10 reps | |
| Knee extension with resistance ( 90°-30°) | 3 sets x 10 reps | |
| Leg press (70°-10°) | 3 sets x 10 reps | |
| Closed-chain | ||
| - Wall sits | to fatigue x 3 | |
| - Mini-squats (rubber tubing, 0°-40°) | 3 sets x 20 reps | |
| - Lateral step-ups (2-4” block) | 3 sets x 10 reps | |
| Multi-hip machine (flexion, extension, abduction, adduction) | 3 sets x 10 reps | |
| Balance training | ||
| 3x/day, 5 mins | Cup walking | |
| Aerobic conditioning (patellofemoral precautions) | ||
| 1-2x/day, 15-20 mins | Water-walking | |
| Swimming | ||
| Stationary bicycling | ||
| Progress program | ||
| Stair machine (low resistance, low stroke) | ||
| Modalities | ||
| As required | cryotherapy | 20 minutes |
| Goals | Increase strength and endurance | |
| ROM 0°-130° | ||
| Normal gait without varus, hyperextension |