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Bracing

  1. Brace locked 0 for ambulation
  2. Open brace 0-70 for passive range of motion exercises starting immediately post op.
  3. Keep brace locked at 0 for ambulation until quad control allows increases in ROM stops on brace. Increase flexion and extension stops as quad control allows.
  4. Sleep without brace at 4 weeks 5) Discontinue brace at 4-6 weeks as determined by the physician

Range of Motion

  1. Passive range of motion 0-70 starting immediately post op
  2. Advance motion as tolerated after post op week 2
  3. Full range of motion by post op week 8
  4. Motion Exercises:
    1. Flexion
      • Wall slides
      • Chair slides
    2. Extension
      • Extension sitting
      • Prone extension
      • Grastroc/hamstring stretch

Weight Bearing

  1. Weight bearing as tolerated with brace locked at 0 until quad strength is sufficient to increase ROM limitations on brace.

Strengthening Exercises

  1. Straight leg raises
  2. Quad/Hamstring co-contractions
  3. Ankle pumps

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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