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 place a cotton pad behind the knee joint to prevent the lower leg from sinking backwards.
2.Promote blood return: forcefully, slowly and with maximum 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, gradually began to side leg lift and prone rear leg lift exercises, but do not do supine straight leg lift exercises. (10-30 times in each direction / group, 2-3 groups / day)
6.Push patella training: push the patella in all directions with your hands. (5 minutes/group, 2 groups/day)
7.Weight-bearing training: support the knee joint in the straight 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 wear the brace to protect the knee joint in full extension position during rest.
2.Passive knee movement: adjust the range of motion of the brace, and passively flex the knee up to 90°. (5 times/day)
3. Active knee: Passive knee flexion up to 70° and then active knee flexion up to 60°, 2-3 times/day)
4.Weight-bearing and balance training: stand with the knee protected by a brace in a straight position, stand with the feet apart left and right or front and back, alternately move the center of gravity left and right or front and back within the range of slight pain, gradually reach a fully weight-bearing stand with both legs first and then one leg. (5 minutes/group in each direction, 2 groups/day)
Third, the third week after surgery
1.Continue the above muscle training, still wear brace to protect the knee joint in full extension position when resting.
2. Passive knee flexion up to 100°, active knee flexion up to 90°. (Brace protection, 5-8 times/day)
3.Hook the leg exercise: stand on the healthy leg, bend the knee joint of the affected leg and hook the calf backward with force.
4.Walking on the ground with the help of crutches, adjusting the range of motion of the brace from 0° to 60°.
Fourth, the fourth week after surgery
1.Continue the above muscle training, still wear the brace to protect the knee joint in full extension position when resting.
2. Passive knee flexion up to 120°, active knee flexion up to 100°. (brace protection, 10-20 times/day)
3. Walk on the ground with crutches and adjust the brace to move within 0°- 70°, gradually reaching 0°-100°.
V. 5-8 weeks after surgery
1.Continue the above muscle training, still wear the brace to protect the knee joint in full extension position when resting.
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: support protection, 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 brace, 30 min/group, 2 groups/day)
5. Passive knee flexion 0°-130°, active knee flexion 0°-110°. (10-20 times/day)
6. Gradually abandon the crutches and wear the brace to walk, adjust the brace to move within 0°- 80° and gradually achieve normal gait.
VI. 9-12 weeks after surgery
1.Resistance flexion and extension knee training, continue proprioceptive training, still wear the brace to protect the knee joint in the fully straight position 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 and 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 0°-90°, and wear the brace for weight-bearing walking.
Seven, the fourth month after surgery
1.Active flexion and extension of the knee joint angle is basically the same as 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, rehabilitation training pain such as rest for half an hour can be basically eliminated is normal, such as rehabilitation with special discomfort timely follow-up. The knee extension brace was braked for 6 weeks, and partial weight-bearing of the affected limb was started 2 weeks after surgery, but the knee extension position must be maintained with the brace. Passive functional knee flexion was started at 4 weeks, with attention to the closed chain type to limit the range of motion from 0 b to 90 b. Active knee flexion was started at 6 weeks postoperatively, and >90b knee flexion was started at 8 weeks. full weight-bearing was abandoned at 10 weeks.