ACL Protocols Flashcards
What is a hinged orthosis (hinged-knee brace) with a locking mechanism used for?
Restricts allowable ROM
Typical Duration of Hinge Brace wear?
Typical worn for the first 6 weeks following their procedure
Brace locked in full extension during ambulation with crutches to prevent graft injury in event of a fall.
Resistance Training General Precautions:
What should be done if a Hamstring Tendon Graft was used instead of a bone-patellar tendon-bone graft is used?
Exercise Progression should be more gradual
If a Hamstring Tendon Graft was utilized what exercises should be done cautiously?
Knee Flexor Strengthening
If a Patellar Tendon Graft was utilized what exercises should be done cautiously?
Knee Extensor Strengthening
When squatting upright what motion of the knee should be avoided/corrected? (Closed-Chain)
Knees do not move anterior, as the increases shear forces on the tibia thus putting excessive strain on the graft
What Open-Chain exercise should be avoided during the first 6 weeks (or as long as 12 weeks)
Short-Arc Quads (between 45 or 30 degrees of full extension)
(also avoid applying resistance to the distal tibia)
What tool can be utilized to measure excessive joint laxity?
Arthrometer
What criteria are required to move from the Maximum Protection Phase to the Moderate Protection/Controlled Motion Phase
Minimal Pain and Swelling
Full, Active Knee Extension (no extensor lag)
At least 110 degrees of Knee Flexion
No evidence of excessive joint laxity
What criteria are required to move from the Moderate Protection/Controlled Motion Phase to the Minimum Protection/Return to Function Phase?
Absence of Pain and Joint Effusion
Full Active knee ROM
At least 75% strength of knee musculature compared to contralateral side
[Hamstring-Quad Ratio] >65%
[Functional Hop Test] > 70% Contralateral Side
No Evidence of knee instability
