First postoperative day.
Objective; to reduce pain and swelling; if patient has pain, give prednisone.
1. elevation of the affected limb with an ice pack around the joint.
2. Perform CPM training: from a fully extended zero degree position to 50 degrees of flexion, but very slowly. Remove the splint during the training.
3. the patient should be fully rested.
4, Isometric training of the quadriceps and the state cord muscles.
5. The patient can go down on the splint; the knee joint should be fixed in the fully extended position.
Second day to two weeks after surgery
Objectives.
a) To enable full extension or hyperextension of the knee joint.
b) Minimize swelling.
c) wound healing.
d) To maintain active control of the quadriceps-quadriceps strength.
e) ability to achieve 90 degrees of flexion.
1. Activity: As on the first day, you can sit up, stand up and walk down to the floor. When walking, the lower limbs should be splinted, with toes on the ground and crutches for partial weight-bearing walking.
2.Walking should be minimized to prevent joint swelling.
3. Perform CPM training: from a fully extended zero degree position to 90 degrees of flexion. Remove the splint during training.
4.Passive knee extension: the patient lies flat on his back with the heel pads elevated so that the knee is fully extended.
5.Perform the last 5 degrees of quadriceps extension training: add a pad (round pillow) under the country fossa about 15 cm in diameter.
6.Quadriceps straight leg raise training.
7, Perform muscle electrical stimulation if necessary.
8.Joint mobility: full extension position to 90 degrees. The knee joint can be placed on the bedside for passive flexion.
9.Patellar mobility training if necessary – pushing the patella (pushing medially and laterally).
10, active training of the country rope muscle, but not resistance.
11.The patient stands on the toe of the good leg with weight, and then lifts the affected leg to swing back and forth.
12.On the fourteenth postoperative day, the patient should be able to walk with the splint fully weight-bearing (i.e., weight-bearing with the heel on the ground).
2 to 6 weeks postoperatively
Objectives.
a) To increase knee flexion to 135 degrees.
b) To reduce knee swelling and increase muscle strength.
1.Activities: Patients perform bed and bedside activities; with splints they can walk with full weight bearing (heel to heel), and remove splints when moving around the house.
2.Quadriceps functional exercise – straight leg raise.
3.Last 5 degrees of extension exercise – padding under the Kokomo fossa.
4.State cord muscle training; if the knee joint can be fully straightened, the patient can lie flat on his back with the hip joint flexed 90 degrees, and then use the gravity of his own calf to bend.
5.Practice going up and down steps: initially 4 inch steps; gradually increase to 6 inch; also can do slow up and down stairs training. Up and down the steps or up and down the stairs, it is best to have a cane in your hand, and then remove the cane when you have enough strength.
6.If the knee flexion can reach 150 degrees, you can train on a bicycle (on a bicycle training machine, not a real bicycle).
7.You can swim after the wound has healed. You can walk forward or backward in the pool.
Six to nine weeks after surgery
Objectives.
a) The knee joint can reach full, normal extension and flexion (extension: 0 degrees, flexion: 150 degrees).
b) To further restore knee function.
1. Activities: full weight-bearing walking with the splint removed; ability to swim and walk in water.
Vibrate up and down kicking water or parallel vibration or forward and backward at the pool (if the patient feels physically able); practice running in waist-deep water; also ride a bicycle outdoors (note; hips must not leave the seat); walk quickly.
2. resistance training of the national cord muscle.
9 to 12 weeks after surgery
Objectives.
a) To increase the strength of the muscles.
b) To further refine the function of the knee joint and to increase the duration of muscle strength.
1. activity: full weight-bearing walking.
2. straight leg raising.
3. last 5 degrees of extension.
4. brisk walking.
5. practice running on flat roads.
6, free cycling.
7.Resistance training on Cybex machines.
After 12 weeks
Objective.
Complete restoration of normal knee mobility; further enhancement of knee function, strength, flexibility.
1. Performing various activities.
2. complete weight-bearing exercise and walking.
3.Progressive calf training; squatting (no more than 45 degrees); standing on tiptoe (pointing both toes to the ground and standing up).
4.Running straight ahead on a flat road, not exceeding 1/2 of the maximum speed.
5.Running up the steps (down the steps to walk down).
6.Training on a bicycle.
7, long jump training (first two legs, then gradually transition to one leg).
8, jumping off steps or boxes.
14 weeks after surgery
It is advisable to come to the hospital for a review at 14 weeks after surgery to determine if you can do sports.
1. training and activity.
2, light physical activity (e.g., running).
3. Two conditions must be observed when doing these exercises: first, there is no swelling in the joint; second, the joint mobility has fully returned to normal. At the same time, the strength of the quadriceps and the national cord muscle reaches 3/4 of the normal strength. in addition, the Lachman test is negative.
6 months after surgery
1. Any functional exercise can be done to further perform major exercises. However, it is required that the quadriceps strength should reach 90% of normal strength. For one year after surgery, the joint should be on a knee brace while doing all these activities.
2. Perform figure 8 running training, i.e. run figure 8. First, run the big figure 8, and run very slowly. Then gradually decrease the figure 8 and, at the same time, increase the speed of running. Do 10 times per group.