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ACL RECONSTRUCTION

ACL RECONSTRUCTION. T. Andrew Israel, MD Luther Midelfort Orthopaedic & Sports Medicine Center. INCIDENCE IN FEMALES. Debate as to why more ACL injuries in females Number of variables Q-angle, Jump/landing technique, menstrual cycle, notch size, level of experience, and others.

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ACL RECONSTRUCTION

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  1. ACL RECONSTRUCTION T. Andrew Israel, MD Luther Midelfort Orthopaedic & Sports Medicine Center

  2. INCIDENCE IN FEMALES • Debate as to why more ACL injuries in females • Number of variables • Q-angle, Jump/landing technique, menstrual cycle, notch size, level of experience, and others

  3. REHABILITATION GOALS • Return athlete back to competition as soon as possible but also as safely as possible • Full range of motion • Equal strength • Pass sport cord test and functional testing that is sport specific

  4. PHASE 1(0-2wks) • Range of motion emphasized • Weight bear as tolerated with post-op brace and crutches • Cryotherapy use important • Exercises include: heel slides, extension hangs, Quad sets/SLRs, 1/3 knee bends, and toe/heel raises

  5. PHASE 1(0-2wks) • Sport cord exercises if pt is able to use sport cord o/w use Theraband • Exercises include: 1/3 knee bends, carpet drags, and gas pedals • Stationary cycling in spinning mode-adjust seat height • Upper body/trunk free weights-light

  6. PHASE 2(2-6wks) • Continue motion exercises & use of stationary cycling • Sport cord exercises • Begin balance exercises-unilateral balance with reaches with uninvolved leg • Aquatic Therapy • Functional knee brace at 4-6 weeks

  7. PHASE 3(6-12wks) • Lower body stretching • Sport cord exercise-add single leg 1/3 knee bends & forward/backward resistive walk to march • Jogging at 8 weeks • Stairstepper-light resistance • Outdoor biking-WITH brace on! Stay on flat ground in the saddle

  8. PHASE 3(6-12wks) • Walking as much as comfortable • 8-10 weeks begin slide board • Hip CKC exercises • Balance exercises

  9. PHASE 4(12-16wks) • Sport cord exercises-prepare for sport cord test at 16-20 weeks post op • Forward/backward jogging with sport cord • Side to Side stepping(lateral agility) • Free weights-add lower body exercises - Seated leg press/hip sled, ham curls, calf raises, and Ab/adduction

  10. PHASE 5(16-20wks) • Sport cord test • Rollerblading(flat ground) • Intro to jogging outside • Intro to golf

  11. PHASE 6(20-24wks) • Athletic Skill drills(sport specific) - begin at 50% and increase as tolerated • Shark Test • LEFT test • 6-9 months postop - Intro to sport if cleared by Physician

  12. SUMMARY • Rehab program is NOT going to follow the timelines listed for each athlete • Every athlete is different • Strength prior to surgery/injury will affect the rehab • Motivation of the athlete to do rehab outside of rehab sessions also important

  13. SURGERY

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