Bracing
- Brace locked at 20° for the first 4 weeks except for range of motion exercises
- Open brace for ambulation following x-ray exam (approximately post-op week 4)
- Sleep without the brace on post-op week 4
- Discontinue brace for ADLs (Activities of Daily Living) on post-op week 6.
- Continue brace for rehab exercise until 4 months post-op
Range of Motion
- Begin patellar mobilization immediately post-op
- Range of motion exercise to begin immediately post-op. Goal: 0-90° at week 4.
- Flexion
- — Wall slides
- — Chair slides
- Extension
- — Extension sitting
- — Prone extension
- — Gastroc/hamstring stretch
- Progress range of motion to full beginning week 5
- Full range of motion by post-op week 8
Weight Bearing
- Begin 25% weight bearing following x-ray exam (approximately post-op week 4)
- Add 25% weight bearing every 2-3 days until 100%
Conditioning and Strength Training
- Stationary biking to begin when weight bearing is initiated
- Mini-squats/leg press/toe raises/ham curls to begin when 50% weight bearing
- Stairmaster/treadmill walking to begin when 100% weight bearing
Lifestyle Modifications
- Achieve an optimal body weight
- Wear shock-absorbing shoes and avoid hard surfaces
- Safe exercise every day
- Top 10 recommended activities:
- Swimming
- Aquatic exercises
- Biking
- Health rider
- Rowing machine
- Walking
- Golf
- Light hiking
- Cross country skiing
- Low impact aerobics
- Proper nutrition through diet and supplementation:
- Calcium: 600 to 1200 mg
- Vitamin C: 1500 mg
- Vitamin E: 400 IU (international units)
- Magnesium 400 mg
- Multivitamin that includes trace minerals
- Glucosamine (750 mg) and chondroitin (600 mg). Double this quantity for the first 3 months.
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