I. Precautions: 1, the methods and data provided in this program are formulated in accordance with the general routine, the specific implementation of the need to be different depending on their own conditions and surgical procedures, completed under the guidance of a doctor. 2. Pain during functional exercises is unavoidable. If the pain subsides to the original level within half an hour of stopping the exercise, it will not cause damage to the tissues and should be tolerated. 3.Muscle strength exercises should be focused on practicing until the muscles are sore and fatigued, and then proceed to the next group after sufficient rest. The number of exercises, time and load depends on your own situation, and should be practiced on the healthy side at the same time. The improvement of muscle strength is the key factor of joint stability, must be practiced seriously. 4, in addition to the surgical limb braking protection, the rest of the body parts (such as the upper limbs, waist and abdomen, the healthy side of the leg, etc.) should be practiced as much as possible to ensure physical fitness, improve the overall circulation and metabolism level, and promote the recovery of the surgical localization. 5, early joint mobility (flexion, extension) exercises, only once a day, and strive to improve the angle can be, avoid repeated flexion and extension, multiple exercises. If there is no progress in flexion angle for a long time (>2 weeks), there is a possibility of joint adhesion, so we should attach great importance to it and insist on completing the exercises. 6.Ice packs should be applied for 15-20 minutes immediately after mobility exercises. If you usually feel swelling, pain and warmth in the joints, you can apply ice again, 2-3 times a day. 7, the swelling of the joints will be accompanied by the entire exercise process, swelling does not increase with the angle of the exercise and the increase in the amount of activity is a normal phenomenon, until the angle and muscle strength basically return to normal swelling will gradually subside. Sudden increase in swelling should be adjusted to practice, reduce the amount of activity, and in serious cases, should be timely follow-up. Early straight splint fixation period (0-4 weeks) Purpose: to reduce pain, swelling; early muscle strength and passive mobility exercises to avoid adhesion and muscle atrophy. Except for some combined cartilage injury patients, early can wear straight splint vertical full weight bearing, but not too much walking, not to mention walking as an exercise method. Otherwise, it is very easy to cause joint swelling and fluid accumulation, affecting functional recovery and tissue healing. 1, the day of surgery: after the anesthesia subsides, start to move the toes; if the pain is not obvious, you can try to contract the quadriceps muscle (i.e., the muscles of the anterior thigh tense and relax). 2. One day after surgery: (1) Move the toes – move the toes vigorously, slowly and as widely as possible. 5 points/group, 1 group/hour. (Important for promoting circulation, reducing swelling, and preventing deep vein thrombosis) (2) N rope muscle (posterior thigh muscle group) isometric exercises – the affected leg forcefully press down on the padded pillow, so that the posterior thigh muscle tautness and relaxation requirements are the same as the above, more than 500 times/day. 2 days after the operation: 1, continue the above exercises. 2, quadriceps (anterior thigh muscle group) isometric exercises that thigh muscle tensing and relaxation. Do as many as possible without pain. (More than 100 times/day) 3, can help the crutches down to walk, but only to go to the toilet but the necessary daily activities. 4. Separate the feet under weight-bearing and balance protection, and move the center of gravity alternately from side to side within the range of slight pain, and gradually transition to standing on one leg with full weight-bearing. (See Appendix 1 – Figure 7). –Separate the feet anteriorly and posteriorly, move the center of gravity, and gradually transition to full single-leg weight-bearing stance. (See appendix 1-figure 22). 5 minutes/times, 2 times/day (d) 3 days after surgery 1. Continue and strengthen the above exercises. 2, rear leg raising exercises: prone position, rear leg raising until the foot is 5 cm from the bed, 30 times/group, 2-4 groups/day, 30 seconds rest between groups. absolutely no straight leg raising exercises within 4 weeks! (E) 1 week after surgery The doctor will decide whether to start flexion exercises according to the situation 1. Start flexion (leg bending) exercises, within 0°-60° isometric range of slight pain. Should be completed by the rehabilitation physician, or with the doctor’s permission in the rehabilitation program under the guidance of their own practice (methods see appendix “seated leg drop”), because the early practice is still a certain degree of danger, so do not practice blindly, otherwise it may lead to adverse consequences. 2, after flexion exercises, if there is obvious warmth and swelling in the joints, immediately apply ice for about 20 minutes. There is no need to ice. 3, start stretching exercises (sitting suspension): in the heel of the pillow, so that the affected leg completely off the bed, relax the muscles to make the knee natural extension. (See Appendix 1 – Figure 14) 30 minutes / times, 1 time / day. Thereafter, perform knee flexion exercises every day or every other day, and keep the knee joint in a straight splint after the exercises. The angle of flexion should be gradually increased to the extent that it is slightly painful, and the thigh muscles must be completely relaxed during the exercise to avoid excessive pulling on the internally displaced tibial tuberosity. Methods can be used to start the sitting or lying position holding the knee to practice flexion. (See Appendix 1 – Figures 11 and 12). Hold the knee to the beginning of the pain to hold 10 seconds, slightly relax and rest for 5 seconds, and then hold the knee, the whole process is controlled within 20 minutes, once a day, the angle of progress can be (the whole process of the exercise can not be completely straightened rest, repeated flexion and extension). Second, the middle period – mobility and muscle strength exercise period (4-8 weeks) Purpose: to strengthen the mobility exercises, in 4-6 weeks to reach the full range. Strengthen the muscle strength exercises to improve joint control and stability; gradually improve the gait. At this stage, the muscle strength level is low, the tissue has inflammatory reaction, and the healing is still fragile. Therefore, endurance exercises with small loads are the main focus. Choose light load (the load of completing 30 movements that feel fatigue), 30 times/group, 2-4 groups of continuous exercises, rest 30 seconds between groups, until fatigue. (i) 4 weeks after surgery: according to the situation decided by the doctor to start joint mobility exercises. 1. Start flexion exercises (flexion exercises to 0°-60° range, if basically painless can be close to 90°. It should be done by the rehabilitation doctor or under the guidance of the rehabilitation program with the doctor’s permission. Since early exercises are still dangerous, it is not allowed to practice blindly without authorization, otherwise it may cause adverse consequences). See Remarks for flexion exercises. Apply ice for about 20 minutes immediately after flexion exercises. If you have the usual feeling of warmth and swelling in the joint, you can apply ice 2-3 times/day. 2, start stretching exercises (sitting suspension): in the heel of the pillow, so that the affected leg completely off the bed, relax the muscles so that the natural extension of the knee joint. (See Appendix 1 – Figure 14) 30 minutes / times, 1-2 times / day. 3.*If you can easily finish standing on one foot with the affected leg, start walking with a single crutch (supporting on the healthy side). If there is no obvious instability of the joint, you can take off the crutches for indoor walking. (ii) 5 weeks after surgery: 1. Extension can be almost the same as that of the healthy side (non-operated leg). 2. 2. Flexion up to 0°-100° range. Gradually adjust the splint or knee brace to 0°-70° range of flexion and extension, and increase the angle every 3-5 days. If joint instability is obvious during walking and weight bearing after adjustment, reduce the angle back to the pre-adjustment angle. 4, start prone position “hook leg exercise”, 30 times / group, 2-4 groups / day. (Methods such as appendix 1-figure 18, sandbags as a load, within the range of motion of the splint, ice immediately after the exercise.) (5) Start active flexion and extension exercises and strengthen them to reinforce muscle strength and joint flexibility. (iii) 6 weeks postoperatively: (sleep without splinting) 1. Walk completely off crutches. Adjust the splint or knee brace to 0°-110° range of flexion and extension. 3. Start the standing “leg hook” exercise. (See Appendix 1-Figures 17, 18, and 19). Static exercise, flexion to a pain-free angle held for 10-15 seconds. 30 times/set, 4 sets/day. 4. Begin anterior-posterior and lateral straddle exercises. 5.Start static squatting or sliding against the wall exercises at a pain-free angle. (See appendix 2-figures 1 and 2.) 6.Strive to achieve normal gait walking. (C) 7 weeks after surgery: 1. Passive flexion up to 140°. 2.According to the muscle strength, decide to start the affected side of the single leg 45 ° position semi-squatting flexion and extension of the knee exercises. 5 minutes / times, 4 times / day. 3.Stationary bicycle exercises, no load to light load. 30 minutes/times, 2 times/day. (D) 8 weeks after surgery: 1, passive flexion angle up to the same as the healthy side. 2.Gradually try full squat under protection. 3.Strengthening muscle strength, see appendix 1-figures 18, 19; appendix 2-figures 4, 5, 10, 11, (but do not increase the load, only increase the angle, frequency and time of the exercise.) III. Post-phase: (8 weeks – 3 months) Purpose: To strengthen the joint mobility to the same level of flexibility as the healthy side. Strengthen muscle strength and improve joint stability. Resumption of daily life and gradual recovery of athletic ability. *As the level of muscle strength improves, absolute strength exercises are the main focus in the middle period. Choose medium load (the load of fatigue to complete 20 movements), 20 times / group, 2-4 groups of continuous exercises, rest 60 seconds between groups, until fatigue. 1, daily prone position flexion so that the heel touches the buttocks, continuous stretching 10 minutes / times. 2.Start kneeling exercises (see appendix 2-figure 14). 3.Start pedaling exercises (see appendix 2-figure 12). 4.Start the knee circling exercise (see appendix 2-figure 15). 5.Start jumping up and down exercises (see appendix 2-figure 16). 6.Begin lateral straddle jump exercises (see Appendix 2-Figure 13). 7. Start Swimming, Rope Skipping and Jogging. 8. Athletes begin to specialize in the basic movements. During this period, the reconstructed ligaments are not yet strong enough, so the exercises and training should be gradual, not forced or blindly advanced. And should strengthen the muscle strength to ensure the stability and safety of the knee joint in sports, if necessary, can wear knee pads to protect, but only advocate the use of strenuous exercise or confrontation. V. Resumption of exercise: (after 3 months) Purpose: Full resumption of exercise or strenuous activities. Strengthening of muscles and stability of joints during running and jumping. Comprehensive or specialized training. This period emphasizes the improvement of the maximum strength, the use of large loads (the completion of 12 movements that fatigue load), 8-12 times / group, 2-4 sets of continuous exercises, rest 90 seconds between sets, until fatigue. Remarks: I. Flexion exercises: choose any one of the following methods. Once a day, strive for a slight increase in the angle can be. If there is any special discomfort during or after the exercise, please inform your doctor in time. Do not straighten and rest during the exercise, repeatedly flexion and extension, otherwise it will affect the effect, and is very easy to cause swelling. Violence is absolutely prohibited. 1, patellar luxation (start after removing the cast): push the edge of the patella, up and down, left and right direction (not to the lateral push!) Slowly and forcefully push the patella to the limit. 20 repetitions in each direction, 2-3 times/day. Can be performed before flexion exercises. 2, sitting (or supine) position hanging leg: sitting on the side of the bed, below the knee hanging out of the bed. Relax the thigh muscles under protection, so that the calf naturally sagging, to the limit of protection for 10 minutes. If necessary, load can be added at the ankle joint. 3, supine leg drop: lie on the bed, thighs perpendicular to the bed (hold the legs with both hands to fix), relax the thigh muscles, so that the calves naturally droop, if necessary, can be added to the ankle joints load (the load should not be too large, otherwise the muscles can not be relaxed, i.e., no effect). Requirements as above. See Appendix 1 – Figure 9. 4, seated “top wall”: sitting on a chair, the affected side of the toe of the wall or fixed, slowly move the body forward to increase the angle of flexion of the knee, feel the pain to remain immobile, a few minutes after the pain disappeared or lowered, and then move forward, to the limit. The whole process is controlled within 30 minutes. See appendix 1-figure 10. 5, prone knee flexion: prone position (face down on the bed), legs naturally stretched, hold the affected leg ankle joint, so that the knee flexion (can be a long towel or a wide band tied to the ankle, in order to facilitate the pulling). Or by others to help. 6, active flexion and extension exercises: (after passive flexion) sitting position, feet do not leave the bed. Slowly and forcefully, maximize knee flexion, hold for 10 seconds and then slowly straighten. 10-20 repetitions/set, 1-2 sets/day. See appendix 1-figure 13. ii. the exercise method of stretching and flexing: stretching exercises in the muscles and the back of the joints of the tugging sensation and slight pain is normal, not to contract the muscles to fight against, should be completely relaxed, otherwise it will be ineffective. The weight of the load used in the exercise should not be too large, should make the affected knee dare to relax, continue to 30 minutes, there are obvious pulling sensation is appropriate. Do not rest in the middle of the exercise, otherwise the effect will be affected. 1, seated knee extension: sitting position, foot cushion high, above the knee joint at the weight. Completely relax the muscles and hold for 30 minutes. 30 minutes/time, 1-2 times/day. See Appendix 1-Figure 14. 2. Prone Suspension: Prone, below the knee hanging outside the bed, weights at the ankle joints. See appendix 1-figure 15. requirements as above. 3. active stretching: