I. Early stage (0-7 days of surgery)
1. The day of surgery.
Ankle pump exercise: after anesthesia subsides, start moving the toes and ankle joint. The method is hard, slow, full range flexion and extension of the ankle joint, 5 minutes/group, multiple groups/hour.
Quadriceps isometric exercises: If pain is not obvious, muscle tensing and relaxation exercises for the front of the thigh are feasible.
2. Day 1 after surgery.
Ankle pump exercise: do as much as possible.
Quadriceps isometric exercises: muscle tensing and relaxation exercises for the front of the thigh, do more without increasing pain (more than 500 times/day).
N cord muscle isometric exercise: put a pillow under the knee of the affected limb, make the posterior thigh muscle tense and relax to press down the pillow with force, do as many times as possible, more than 500 times/day.
The first day after surgery can walk on crutches, but the affected limb should be under the protection of the splint, the affected limb crutches do not bear weight.
3. Continue the ankle pump exercises on the 2nd postoperative day.
Straight leg raising exercise: straighten the knee joint, raise the straight leg until the heel is 15cm from the bed, keep it until the force is exhausted. 2~3 times/day.
Lateral leg raise exercise: 10 times/set, 2 sets/day.
Walk on crutches, but the affected limb should be under the protection of splint or brace, and the affected limb is not weight-bearing on crutches.
4.Continue the above exercises on the 3rd postoperative day.
Weight-bearing balance exercise: separate both feet under the protection of crutches, alternately move the center of gravity from side to side within the range of slight pain, 5 minutes/time, 2~3 times/day.
Flexion exercises: the patient tries to sit on the edge of the bed and drops the knee joint naturally to 30° within the micro-pain range.
5. Continue the above exercises on the 4th postoperative day.
Strengthen the knee weight-bearing balance exercises: gradually until you can stand on one foot with the affected limb. If you can do it easily, you can start walking with a single crutch (holding on the healthy side). Be careful not to walk fully weight-bearing, but only one-third of the weight of the affected limb.
Flexion exercises to 0°~60° range.
6. Continue the above exercises on the 5th postoperative day.
Flexion exercises to 70°~80° range, and active flexion and extension exercises can be started.
Extension exercises: supine position, pillow at the heel, make the affected limb completely leave the bed, relax the muscles to make the knee joint extend naturally, 10 minutes/time, 1~2 times/day.
7. Continue the above exercises on the 6th~7th postoperative day.
Passive flexion exercises to 90° range, active flexion and extension exercises also to 90°.
Extension exercises: supine position, pillow at the heel, make the affected limb completely leave the bed, relax the muscles to make the knee joint naturally extend, 10 minutes/time, 1~2 times/day.
Second, the initial period (2 weeks-4 weeks after surgery)
1. 2 weeks after surgery, passively flex the knee joint to 100°.
Strengthen muscle strength exercises, one straight leg raising exercise up to 6 minutes.
Walk with crutches and one third weight bearing on the affected limb.
2. Passive flexion to 110° at 3 weeks postoperatively.
Intensify active flexion exercises.
Strengthen muscle strength exercises.
Sitting or lying knee flexion exercises: hold the knee to the place where you start to feel pain for 10 seconds, relax slightly and rest for 5 seconds, then hold the knee tightly, repeat the exercises for 20 minutes, once a day.
Walk on crutches, with one-third of the weight on the affected limb.
3. Sleep without splint or brace 4 weeks after surgery.
Passive flexion to 115°.
Begin static squatting or sliding exercises against the wall.
Strive to achieve normal gait for walking.
Walk with crutches, with one-third of the weight on the affected limb.
Third, the middle term (5 weeks-3 months after surgery)
1.Passive flexion of the knee joint to 120° at 5 weeks after surgery.
Stationary bicycle exercises: no load to light load, 30 minutes/time, 2 times/day.
Walking with crutches, one-third weight-bearing on the affected limb.
2. Passive flexion of the knee up to 150° i.e. full range of the same as the healthy leg at 6 to 8 weeks postoperatively.
Full weight-bearing can be started at 8 weeks postoperatively.
Attempt a protected full squat movement.
Strengthen muscle strength exercises, increase the number of straight leg raise exercises and static squat exercises.
3. Splint or brace can be removed at 10 weeks to 3 months postoperatively.
Active flexion of the knee joint at the same angle as the healthy leg and without significant pain.
Flex the knee joint in prone position so that the heel touches the buttock, and keep stretching for 10 minutes/time.
Begin kneeling exercises and pedaling exercises.
IV. Late stage (4-6 months)
Rehabilitation purpose: Full restoration of all activities of daily life; strengthening of muscle strength and joint stability.
Rehabilitation precautions.
Large load should be used (i.e., the amount of load to complete 12 movements that is fatigue), 8~12 times/group, 2~4 groups of continuous exercises, with 90 seconds rest between groups until fatigue.
Exercise plan.
Continue the above exercises.
Knee wrapping exercises.
Jump up and down exercises.
Lateral jumping exercises.
Start swimming, jumping rope and jogging.
Athletes can begin to practice basic movements in specific sports.
Knee brace can be worn for protection during strenuous exercise.
V. Recovery exercise period (7 months-1 year after surgery)
The purpose of rehabilitation: 7 months after surgery, the athlete can start to resume sports gradually; later on, the athlete can improve the maximum strength. By 10 months postoperatively, the patient will start to resume full-scale sports or strenuous sports; gradually resume special training; strengthen muscle strength and joint stability during strenuous activities; the muscle strength of the affected side will reach 85% or more of the healthy side, and there will be no pain or obvious swelling during sports.