ACL Allograft Reconstruction Protocol The intent of this protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone an ACL ⦠... quad sets, leg raises in multiple planes (except hip flexion). Loss of knee extension has been shown to result in a limp, quadriceps muscle weakness, and anterior knee pain. We are less aggressive initially with hamstring tendon grafts because soft tissue to bone healing takes longer (approx 12 weeks) in comparison to bone to bone (approx 8 weeks). Up until now, only 2 studies have compared QT to hamstring tendon (HT) autograft. Anterior Cruciate Ligament (ACL) and Meniscus Repair Rehabilitation Protocol Progression to Phase IV: ⢠Full ROM ⢠No effusion ⢠No pain ⢠Proprioception 80 to 100% of non-involved side ⢠Isometric quad strength 80% of non-involved side ⢠Hamstring to quad ratio 70% ⢠Minimum of 10 weeks post-op Weight Bearing: Full, with crutches for safety . Sports Medicine Rehabilitation Protocols. / Stretches Strengthening / Rehab Exercises Massage / Soft Tissue release ITB / Quads / Post Knee Post-Op Swelling reduction Acupuncture / Dry Needling GENERAL GUIDELINES Focus on protection of graft during primary re-vascularization (8 weeks) and graft fixation (8 â12 weeks) For ACL reconstruction performed with meniscal repair or transplant, defer to ROM and weightbearing precautions outlined in the meniscal repair/transplant protocol. ¥ KNEE BRACE MUST BE WORN WITH THE STRAIGHT LEG RAISE (SLR) ... 10% difference in quads, equal in hamstrings. grafts and hamstring grafts. REHAB PROTOCOL FOR ACL RECONSTRUCTION USING PATELLAR TENDON AUTOGRAFT . Groin & Hip. Continue to advance up to 25 lbs. ... Quad sets, hamstring sets (consider NMES for poor quad sets) The following anterior cruciate ligament (ACL) reconstruction rehabilitation protocol is specific to patients with a quadriceps tendon autograft. The graft has an initially more difficult recovery because your quad muscles are the most important to full recovery after ACL reconstruction. Weeks 0 to 3: Protective Phase. Download PDF ... Quad tendon repair with allograft post-operative physical therapy protocol. People can warn you and tell you, but you never really know until you are experiencing it. This graft is typically 7-8mm in diameter. Recently, the quadriceps tendon has gained popularity for use as a graft source for ACL reconstruction. ACL WITH QUAD TENDON GRAFT WITH MENISCAL REPAIR PHASE I (0-3 WEEKS) DATES: Appointments Physical therapy 2-3x/week, beginning 2-5 days post-op Rehabilitation Goals ⢠Full extension symmetrical to contralateral knee before the first post-op visit at 2 weeks ⢠PROM 0-90° ⢠20° SLR without quad lag (Not ACL protocol⦠MACI Rehabilitation MCL sprain Meniscus repair Microfracture surgery OATS protocol Patellar or Quad tendon repair Patellar stabilization/Tibial Tubercle Osteotomy Patellar tendinitis and Chondromalacia Patellar tendon debridement Patellofemoral rehabilitation PCL reconstruction Single leg exercise progression. replacing the torn ACL with a graft. The objective of the study was to compare the results of a primary anterior cruciate ligament reconstruction (ACLR) using the press-fit fixation technique for a quadriceps tendon (QT) graft to a standard quadrupled hamstring (HT) graft with interference screw fixation. The following is a general guideline for progression of rehabilitation following ACL patellar tendon autograft reconstruction. If a hamstring autograft was used, please refer to the âAnterior Cruciate Ligament (ACL) Reconstruction: Hamstring Autograftâ protocol on the Ohio State Sports Medicine website. ACL Reconstruction with Patellar Tendon Autograft 2020-04-08T13:03:32-04:00 This protocol is intended to be a general guideline. Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. ACL Patellar Tendon Graft Protocol Physical Therapy protocols provided by Dr. LaFrance of Hamilton Orthopedic Spine & Sports Medicine. SLR Brace will be worn for 4 weeks to protect graft, 0 to 90 degrees GOALS OF PHASE: ROM, Control swelling/inflammation, Quad control . The following is a general guideline for progression of rehabilitation following ACL patellar tendon autograft reconstruction. POST-OPERATIVE REHABILITATION PROTOCOL AUTOGRAFT BONE-PATELLA TENDON-BONE And ALLOGRAFT PROTOCOL PHASE I-EARLY FUNCTIONAL ... ¥ Review of patient ACL ( BONE-PATELLA TENDON-BONE GRAFT ) Home Instructions. 2) Solid, isometric quad contraction. without quad fatigue, then advance 5 lbs. Durham: Rehab and Sports Therapy Center Rehab 3: One High Standard, Three Local Partners For more information go to www.rehab-3.com ACL Reconstruction Protocol (Hamstring Graft) Week one Week two Initial Evaluation Evaluate Range of motion Joint hemarthrosis Ability to contract quad/vmo Gait (generally WBAT in brace) ... Quad sets, hamstring sets (consider NMES for poor quad sets) In this case, use of a patellar tendon graft can aggravate the pre-existing pattelar tendonitis, and may not be the best graft choice. Follow PCL rehabilitation guidelines. Patellar-Quadriceps Tendon Repair Protocol p. 1 Patellar-quadriceps Tendon Repair Protocol Applicability: Physician Practice Date Effective: 3/2017 Department: Rehabilitation Services Date Last Reviewed / or Supersedes: none Date Last Revision: 3/2017 Administration Approval: Amy Putnam, VP Physician Services Purpose: Define the protocol to be followed for all patients referred from ⦠Quad strength > 60% uninvolved. procedures Goals Activity Notes/Comments STAGE ONE: WEEKS 1 â 2 Physio Treatment R.O.M. For the athlete that is done, or nearly done growing, the surgical reconstruction involves placing a graft within drill holes (tunnels) in the thigh (femur) bone and shin (tibia) bone. Download PDF. With a hamstring graft, most ACL surgeons are doubling over both the semitendinosus and the gracilis tendon to create a graft comprised of 4 strands of tendon. I am not familiar with the quad tendon graft, I would guess that it is a fairly new procedure therefore there probably would not be any long term studies out there that you could read about. Solid, isometric quad contraction 3. ACL Patellar ... Primary goal is to achieve terminal knee extension and good quad control. REHAB PROTOCOL FOR ACL RECONSTRUCTION USING ALLOGRAFT . Discharge Instructions & Physical Therapy Protocol for ACL Reconstruction Quadriceps Tendon. Brace: Knee immobilizer when walking . PATELLA TENDON GRAFT . Getting the quads to fire again after taking a piece of the quad tendon out, is so difficult as I later found out. ACL Reconstruction Rehabilitation Protocol One of the most common complications following ACL reconstruction is loss of motion, especially loss of extension. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. A retrospective cohort study with a 12-month follow up provided data for 92 patients. Clinical and functional outcomes after ACL reconstruction using allograft tissue compared to autograft tissue appear to be similar. General Guidelines Brace: Locked in full extension for walking and sleeping for first week May allow 90 degrees flexion after first week given: 1) Full extension. ACL Hamstring Tendon Autograft Reconstruction Protocol . ACL reconstructions performed with meniscal repair or transplant follow the ACL protocol with avoidance of open kinetic chain hamstring work for 6 weeks. The physician staff may advance, delay, or alter this protocol based on individual patient status. Recovery after knee surgery entails controlling swelling and discomfort, healing, return of range-of-motion of the knee joint, regaining strength in the muscles around the knee joint, and a ⦠Consider the Quad Tendon graft for your ACL reconstruction if one of the following applies to you: 1. The acl surgery and grafted into two no effusion or she has been reconstructed graft option is performed by sports rehabilitation following surgery may contact from kim et al. PHYSIOTHERAPY FOLLOWING ACL RECONSTRUCTION PROTOCOL Rehabilitation following Anterior Cruciate Ligament Reconstruction (ACLR) is an essential part of a full recovery. Histologically it has 20% more collagen fibrils per cross-sectional area than the patellar tendon (PT). (a) The ACL reconstruction with a bone-patellar-tendon-bone autograft The middle third of the patellar tendon, complete with its bony attachment at either end, is removed from the ACL-deficient knee. 2. BRIDGE PROGRAM or equivalent may begin at 12-week mark with bone patellar tendon bone graft. Background: The quadriceps tendon (QT) autograft is known as an effective graft for anterior cruciate ligament (ACL) reconstruction and shows a similar functional outcome to the bone-patellar tendon-bone (BPTB) in randomized controlled trials, with a lesser incidence of complications. Flexion: 110 degrees Quad and Patellar Tendon Repair Approved by M. Lemos, MD 10.2014; L. Scola, DPT, OCS, OMT; Review date 10.15 7 Rehabilitation Protocol for Quad and Patellar Tendon Repair Rehabilitation Guidelines: Summary Table Post âop Phase/Goals Therapeutic Exercise Precautions Phase I 1 - 2 weeks after surgery Goals: If patient develops patellofemoral pain or crepitus, D/C open chain immediately. 4. Brace will be worn for 10 weeks to protect graft, 0 to 90 degrees Postoperative Rehabilitation Protocol: Anterior Cruciate Ligament (ACL) Reconstruction . R. Lee Murphy Jr., MD provides d technique guidance for the use of the quad tendon graft for ACL reconstruction. There are several acceptable graft choices: hamstring tendon, patellar tendon and quadriceps tendons. The quad tendon is reliably a 9-10mm graft. ACL reconstructions performed with meniscal repair or transplant follow the ACL protocol with avoidance of open kinetic chain hamstring work for 6 weeks. I would start by asking the surgeon if there were any rehab considerations different from your current protocol or different from how you are rehabing your patellar BTB patients. (Patellar Tendon, Quad Tendon, Hamstring and Allograft) *The rehabilitation for hamstring tendon graft and patellar tendon graft is differentiated within the protocol. Learn more about the rehab, recovery time, & exercise protocols quad tendon injury repairs. Factors such This rehabilitation protocol has been designed for patients who have undergone an ACL reconstruction (HS graft/PT graft/Allograft) in addition to other surgical procedures or conditions that may delay the initial time frame of the rehabilitation process. 3) SLR. DO NOT exceed 25 lbs open chain. The all soft tissue quadriceps graft offers many advantages over other autograft choices.
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