Phase I (Weeks 0 – 4)

• TDWB with crutches and immobilizer/brace locked in extension
• NO RANGE OF MOTION FOR FIRST 4 WEEKS
• Strengthening:
  • Sub maximal quadricep sets, glut sets, HS sets
  • Ankle pumps
  • Patellar mobilizations

Phase II (weeks 4-6)

• WBAT with crutches and T-Scope locking in extension
• Progress PROM/AAROM 
  • WEEK 4- Start 0-30, progress to 0-60 over next 2 weeks as tolerated
• Strengthening:    
  • Continue Quadricep sets
  • SLR’s in abduction and extension and add light resistance
  • Begin SLR’s in flexion in immobilizer 
• Begin gentle stretches (hamstrings, gastrocnemius, ITB, etc.)

Phase III (weeks 6-8)

• WBAT with T-scope unlocked when patient demonstrates a good quad set and SLR flexion without a lag
• Progress PROM to 90 degrees
• Strengthening:
  • Continue SLR in all planes
  • Begin light closed chain strengthening
• Begin balance/proprioception program

Phase IV (weeks 8-12)

• Wean from brace
• Progress PROM/AROM to tolerance
• Begin stationary cycling when 110 degrees of knee flexion
• Strengthening:
  • Continue closed kinetic chain strengthening
  • Begin light open chain isotonic exercises
  • Continue and advance balance/proprioception program

Phase V (weeks 12- 16)

• Progress above ROM, flexibility, proprioception and strengthening program
• Isokinetic test (full ROM/high speeds)
• Begin straight-line jogging program

Phase VI (Weeks 16 – 24)

• Begin sport specific agility program
• Return to play when client meets discharge criteria

Discharge Criteria:

• Full ROM
• No effusion
• No tenderness over patellar tendon or pain with exercise
• Satisfactory strength test (80% of opposite leg)
• Satisfactory completion of straight jogging and sport specific agility program
• Physician approval