ACL重建术后康复程序

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1、PreoperativeTearoftheanteriorcruciateligamentPartialCompleteAvulsion•Reduceswelling•Regainfullextensionunlessrestrictedbybuckethandlemeniscaltear•Increaseflexiontomaximumthatiscomfortable•RcgainadequateQuadricepsHamstringstrengthbyclosedchainexercises•Nopivotingsp

2、ortPostoperative•Discharge-Samedayinthevastmajorityofpatients•Paincontrolisachievedbyusinginf订trationoflocalanaestheticintothejointandwoundplususeofanerveblock•DischargefromHospitalgoalsoMobilisingsafelywithcrutchesincludingdoingstairsoPassivefullextensionandreaso

3、nableflexion(60-90degrees)oOutpatientphysiotherapyappointmentorganisedGoalsfor0-2weeks•Mobilisewiththeaidofcrutchesincludingindoors•Reducebandagoafter24-48hours•Painrelief•Reduceswelling-Icing4-6timesdaily15minuteseachtime•Regainextension-heelraiseandextensionstre

4、tch,quadricepsbraeingexercise•Rcgainflcxionbeyond90degrees•Mobilisepatella(Patellatendongraft)andnoactivehamstringcurls(Hamstringgraft)Goalsfor2-6weeks•Note:Thegraftdoesnothealinthetunnelsforatleast6~8weeks•Weanoffcrutches•Regainsymmetricalhyperextension-heelraise

5、,pronehangs(compareheelheight)•Regainfullflexionbyheelslideusingatowel(compareheel-buttockdistancc)•Minisquats.Bridgingexercises•Proprioceptiveexercisesandimprovejointpositionsense•Closedchainexercises-Exercisebike•Nodrivingfor2-3weeksforleftkneeand4-6weeksforrigh

6、tknee6weeksto3months•Closedchainexercisesandstraightlineactivitiesonly•Gaittraining，corestrengthandbalancctraining•Improvequadricepsandhamstringstrength-exercisebike,crosstrainer,Lunges,singlelegdips•Lowresistaneeandlowweightsbutmorerepetition•Briskwalking,Swimmin

7、g3-6months•Moreintensivestrengthtraining•Openchainexercisesallowed•Startrunningonatreadmill•Regainatleast80%quadricepsandhamstringstrengthcomparedtooppositelegProgresstoshuttleruns,sidestepping,diagonallunges,figureofeightandzig-zagrunsAfter6months•Sportsspecifict

8、raining•Plyometrieexercises•Techniquetraining,plyomctricexercises,corestrengthandbalancetrainingpreventfurtherACLinjuries•Returntosportatapproximately8m