Essential to the success of the procedure is early full extension and quadriceps function. Precautions must be followed to protect the graft and eliminate failure. Some physicians will allow early return to athletics, but studies show this return is high in risk and low in performance.

Immediately post operative
Quad sets into full extension, ankle pumps, and swelling management. Patient is touch down weight bearing.

2 days post operative
Start formal physical therapy, patient is touch down weight bearing. Work on full extension (quad sets) and initiate flexion exercises (heel slides).

2 weeks post operative
Patient should have good quad control and full extension. Flexion should be 90 degrees, patient will increase weight bearing status. Range of motion work is still essential. Effusion and lower leg swelling should be eliminated.

3 weeks post operative
Full extension should be maintained. Increase flexion to 110 – 120 degrees. Start focusing on strength and proprioception.

4-8 weeks post operative
Full motion should be achieved. Accelerate trunk and pelvic control, leg strengthening and proprioceptive work.

8-12 weeks post operative
Increase endurance and strength work. Speed of movements may be increased, but NO running.

3-6 months post operative
Gradual increase in return to normal activities and sport specific conditioning, discuss light jogging with your physician.

6 months post operative
Returning to athletics, functional bracing may be recommended.