POST PROCEDURE PROTOCOL FOR KNEE PROCEDURES

  • No NSAIDS such as Advil, Motrin, ibuprofen, Naprosyn, and Aleve x 2 weeks

  • Pain: Tylenol for mild pain and if needed use mild narcotic provided.

  • Bracing: Use brace during sleep the first 3 nights if able. Sleep is more important so if you cannot sleep and use the brace, feel free to remove it.

  • Driving restrictions: No driving until out of knee locking brace and can safely move foot from gas to brake.  If left leg, must be able to safely use clutch.

  • Work restrictions: Depends on duration of weightbearing restrictions

  • Exercise restrictions: 2 weeks relative rest followed by 4 weeks progressive PT.  No running, jumping, cutting, lunges or deep squats until 8 weeks.

  • Use crutches for __________ days, non-weight-bearing for ________ days

  • Start partial weight bearing WITH knee brace/crutches from days _________

  • Use hinged knee brace locked out for 2 days, then set for ___ - ___ degrees till end of the first week then advance to ___ - ___ degrees till end of week 2

  • Use unloader brace for 6 weeks consistently whenever on your feet

  • Come out of brace for simple non-weight bearing range of motion and gentle isometrics (strait leg quad contractions) 1-2 times daily after the first 2 days of continuous brace wear. Goal is full ROM by 2 weeks

  • f/u for PT in 5-7 days

Activities: In general, with strength and activities, keep pain level below 4/10.
 

First 2 Weeks:

  • Strengthening/Motion: Isometrics always good.  Non weightbearing and passive range of motion is good too. Try to get full range of motion by 2 weeks.

  • Walking: No hiking. May walk on flat ground initially (use crutches if directed above) for 10-15 minutes. If this goes well, may walk 5 minutes longer the next day.

  • Cycling: May gently ride stationary bike for 15 minutes after week 1. Exertion level 1-3/10.

  • Swimming: Use pull buoy alternating with easy kicking (exertion 1-2/10) after week 1.

Weeks 2-4:

  • Strengthening/Motion: Start gentle low load closed chain concentric/eccentrics.

  • Walking: May begin gentle hiking (no more than 30 minutes).

  • Cycling: May ride up to 30 minutes. No getting out of saddle til after week 3. Exertion level 4-6/10.

  • Swimming: May increase kicking intensity (exertion 3-6/10) to alternating with pull buoy. No more than ½ -1 mile.

 

Weeks 4-6:

  • Strengthening/Motion: Progress to moderate load, progressive strengthening.

  • Walking: May progress to longer hikes up to 60 minutes, still no big stepups.

  • Cycling: May ride 60 minutes.  May get out of saddle. Exertion level 7-9/10 during intervals.

  • Swimming: May swim up to 1-2 miles with normal exertion level.  Still encourage breaks with buoy.