I. Postoperative Week 1
1. Correct position: Wear a brace to protect the knee joint in a fully extended position, place the lower leg on a pillow and elevate it, and use a pillow to cushion the leg into a slightly bent position.
2.Promote blood flow back: forceful, slow, maximum range of flexion and extension of the ankle joint and toes. (15 minutes/group, 2 groups/day)
3.Quadriceps (anterior thigh muscle group) isometric training: thigh muscle tensing and relaxation cycle exercises. (>500 times / day)
4, N cord muscle (rear thigh muscle group) isometric training: calf force down the padded pillow, so that the rear thigh muscle tensing and relaxation cycle exercises. (>500 times / day)
5, straighten the leg lift training: straighten the knee joint under the protection of the support to lift the leg upward to the heel from the bed 15M, hold until you feel fatigue and then put down. And gradually start the side leg lift and prone leg lift exercises. (10-30 times/group in each direction, 2-3 groups/day)
6, push the patella training: use your hands to push the patella in all directions. (5 minutes/group, 2 groups/day)
7.Weight-bearing training: support the knee joint in a fully extended position and hold the crutches to the ground to gradually bear some weight.
Second, the second week after surgery
1.Continue the above muscle training, still use the brace to protect the knee joint in the straight position when resting.
2.Passive movement of the knee joint: adjust the range of motion of the brace, increase 15° per day, and gradually reach 90° of passive movement. (5 times/day)
3. Active knee movement: Passive knee flexion up to 70° and then active knee flexion is started. (Range 0° to 60°, 2-3 times/day)
4.Weight-bearing and balance training: straighten the knee joint with the protection of a brace, stand with the feet apart left and right or front and back, alternately move the weight left and right or front and back within the range of slight pain, gradually reaching a fully weight-bearing stand with both legs first and then one leg. (5 minutes/group in each direction, 2 groups/day)
5.Extension training: Remove the support, put a pillow at the heel, make the affected leg leave the bed completely, relax the muscles to make the knee joint extend naturally. (30 minutes/group, 1-2 groups/day; interval as long as possible with flexion and extension training; put on the brace after the exercise)
Third, the third week after surgery
1.Continue the above muscle training, still use the brace to protect the knee joint in extension position during rest.
2. Passive flexion of the knee gradually reaches 100°, active flexion gradually reaches 90°. (Brace protection, 5-8 times/day)
3.Hooking exercise: stand on the healthy leg, flex the knee joint of the affected leg and hook the lower leg backward.
4.Walk on the ground with the help of crutches, and adjust the range of motion of the brace to 60° gradually.
Fourth, the fourth week after surgery
1.Continue the above muscle training, still use the brace to protect the knee joint extension position when resting.
2. Passive knee flexion gradually reaches 120°, active knee flexion gradually reaches 100°. (brace protection, 10-20 times/day)
3. Walk on the ground with crutches and adjust the brace within the range of 0°- 70°, increasing by 5° per day, gradually exceeding 100°.
V. 5-8 weeks after surgery
1.Continue the above muscle training, protect the knee joint at 10° with the brace during rest.
2. Straddle training: anterior-posterior and lateral straddle under the protection of brace, with active and weight-bearing of the affected leg. (30 times/group, 4 groups/day)
3.Static squat training: Protected by braces, back against the wall, feet shoulder-width apart, toes and knees to the front, slowly squatting, gradually increasing the squatting angle to 90°. (2 minutes / time, interval 5 seconds, 5-10 times / group, 2-3 groups / day)
4, proprioceptive training: pedal fixed bicycle, no load gradually to light load. (Wear support, 30 minutes/group, 2 groups/day)
5. Passive knee flexion up to 130°, active knee flexion up to 110°. (10-20 times/day)
6. Gradually abandon the crutches and wear the brace to walk, adjust the brace to move within 0°- 60°, and gradually reach normal gait.
VI. 9-12 weeks after surgery
1.Resistance flexion and extension knee training, continue proprioceptive training, protect the knee joint at 10° with brace during rest.
2. Single-leg semi-squat training: stand on one leg with the affected leg, slowly squat to 45°, then slowly straighten and stand up. (Slow, force control stability, 20-30 times / group, each interval of 30 seconds, 2-4 groups / day)
3.Passive knee flexion angle gradually to the same as the healthy side, “sitting knee” flexion angle and the healthy leg exactly the same, began to gradually protect under the full squat, but at the same time the meniscus suture to perform meniscus surgery to half a year after surgery to complete deep squat.
4. Adjust the range of motion of the brace to 90°, and wear the brace for weight-bearing walking.
Seven, the fourth month after surgery
1.The angle of active knee flexion and extension is basically the same as that of the healthy side.
2.Flex the knee daily in prone position so that the heel touches the hip, and keep stretching. (10 minutes/time)
3.After the angle of “sitting knee” is exactly the same as the healthy side, start kneeling exercises.
4.Remove the support and start pedaling exercises.
8.5 months to 6 months after surgery
1.Progressively resume all activities of daily life.
2.Continue to strengthen muscle strength training.
3. Gradually resume exercise, starting from jogging at a uniform speed forward.
IX. Precautions
1.Muscle training should be done as much as possible without increasing pain, until the muscles are moderately sore and fatigued, then rest fully; joint activities should be done mainly to achieve the target angle, focusing on gradual progress (angle, number of times, duration should be gradually increased).
2. Before removing the brace in the first three months, the brace should be worn during training unless specifically stated or the knee flexion exceeds the brace adjustment range.
3. If stiffness is felt before each training session, hot packs can be applied, and ice packs can be applied for 15-20 minutes after the training session.
4. It is normal for pain during rehabilitation to be eliminated after half an hour’s rest, but if you have any special discomfort during rehabilitation, you should follow up in time.