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Bracing

  1. Brace locked at 20° for the first 4 weeks
  2. Remove brace under PT supervision for passive extension ROM.
  3. Open brace for ambulation following x-ray exam (approximately post-op week 5)
  4. Sleep without the brace on post-op week 6
  5. Discontinue brace for ADLs (Activities of Daily Living) on post-op week 8.
  6. Continue brace for rehab exercise until 4 months post-op

Range of Motion

  1. Begin scar/patellar mobilization immediately post-op
  2. RBegin range of motion exercises at post-op week 4.
    1. Flexion
      • — Wall slides
      • — Chair slides
    2. Extension
      • — Extension sitting
      • — Prone extension
      • — Gastroc/hamstring stretch
    3. Begin ROM only aquatic rehab at 3 wks post-op or when incisions are fully healed. Avoid WB in pool until followup x-ray exam at post-op week 4-5.
    4. Full range of motion by post-op week 8-12

Weight Bearing

  1. Begin 25% weight bearing following x-ray exam (approximately post-op week 5)
  2. Add 25% weight bearing each week until 100%

Conditioning and Strength Training

  1. Stationary biking to begin when weight bearing is initiated
  2. Mini-squats/leg press/toe raises/ham curls to begin when 50% weight bearing
  3. Stairmaster/treadmill walking to begin when 100% weight bearing

Lifestyle Modifications

  1. Achieve an optimal body weight
  2. Wear shock-absorbing shoes and avoid hard surfaces
  3. Safe exercise every day
  4. Top 10 recommended activities:
    1. Swimming
    2. Aquatic exercises
    3. Biking
    4. Health rider
    5. Rowing machine
    6. Walking
    7. Golf
    8. Light hiking
    9. Cross country skiing
    10. Low impact aerobics
  5. Proper nutrition through diet and supplementation:
    1. Calcium: 600 to 1200 mg
    2. Vitamin C: 1500 mg
    3. Vitamin E: 400 IU (international units)
    4. Magnesium 400 mg
    5. Multivitamin that includes trace minerals
    6. Glucosamine (750 mg) and chondroitin (600 mg). Double this quantity for the first 3 months.


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