Nathaniel Stewart, MD

Weeks 1-2
Patient usually presents to PT within 5-10 days. They may or may not have their bandages removed, stitches removed or immobilizer in place. Modify plan accordingly. Stitches are usually removed by the doctor’s office at their first follow up visit. Bandages could be removed and ACE bandage or immobilizer can be replaced.

Begin A/AAROM. Limit flexion to 90º for the first 2 weeks.

WBAT with crutches.  Crutches for 2-3 weeks, discontinue when the patient can ambulate without a limp with normal and painfree gait pattern.

Ice 3-6X/day with elevation.

Patellar mobilizations in all directions (except lateral) and emphasize aggressive medial tilts (i.e. Tilt the lateral edge of the patella up to loosen the lateral restraints) 3X/day for 10-15 minutes.

Quad sets, SLR’s, as tolerated.

Begin to wean from immobilizer (if they have one) as tolerated. Physician will usually mention this at their first post-op visit.

Week 3
Bike (as tolerated by ROM limitations); high seat and no resistance.

TKE in closed kinetic chain: overball, theraband, total gym(double leg, low level)

Patellar mobilizations should continue, tilt should reach 25º.

Week 4
Begin more advanced strengthening including multihip machine, progress closed chain strengthening and balance/proprioception. Move to single leg activity. Plan on return to work or sport activities once cleared from physician.

Please call Northwoods Therapy Associates at (715) 839-9266 with questions.