This rehabilitation protocol has been designed for patients with ACL reconstruction who anticipate returning to a high level of activity early postoperatively. The ACL Rehabilitation protocol for all grafts is the same with the following exceptions:
If a hamstring autograft was used:

• when performing heel slides, make sure that a towel/sheet is used to avoid actively contracting the hamstrings.
• do not perform isolated hamstring exercises until the 4th week post- op.

The following are exclusionary criteria for this protocol:

• Concomitant meniscal repair
• Concomitant reconstruction of another ligament
• Concomitant patellofemoral realignment procedure
• ACL revision reconstruction
• MRI evidence of severe bone bruising or articular cartilage damage noted

The protocol is divided into several phases according to postoperative weeks and each phase has anticipated goals for the individual patient to reach. The overall goals of the reconstruction and the rehabilitation are to:

• Control joint pain, swelling, hemarthrosis
• Regain normal knee range of motion
• Regain a normal gait pattern and neuromuscular stability for ambulation
• Regain normal lower extremity strength
• Regain normal proprioception, balance, and coordination for daily activities
• Achieve the level of function based on the orthopedic and patient goals

The physical therapy is to begin after the 2nd day post-op. It is extremely important for the supervised rehabilitation to be supplemented by a home fitness program where the patient performs the given exercises at home or at a gym facility.