STAGE 1 : Approx first 2 weeks

Adequate analgesia

Swelling management

Gait re-education and mobility

Stretches as required

Exercises : static bike with minimal resistance, Knee ROM exercises, strengthening of knee stabiliser muscles (OKC exercises for hamstrings allowed)

Manual Therapy: Soft tissue and Joint mobilisations as appropriate

Hydrotherapy / Electrotherapy: If available and thought appropriate


Goals required to progress to next stage:

ROM 0-120 degrees

Full quadriceps activation

Minimal joint effusion in morning

Full weight bearing (with aids if required)


STAGE 2: Approx 2-6 weeks


As stage 1 plus:

Increased resistance on static bike

Swimming may be introduced (but not breaststroke leg kicks)

Strengthening muscles with therabands and weights as appropriate

Proprioceptive / balance exercises

Core stability and gluteal control work


Goals required to progress to next stage:

Full range of active movement

Minimal activity related effusion

CKC single leg squat

Single leg stance as good as unoperated side with eyes open


STAGE 3: Approx 6-12 weeks

As stage 2 plus:

Rowing machine / stepper /cross trainer may be introduced

Review lower limb biomechanics and intervene as required


Goals required to progress to next stage:

Bilaterally equal single stance proprioceptive tests, including on uneven surface

Bilaterally equal strength of hamstrings, adductors, abductors and gastrocnemius


STAGE 4: Approx 12 weeks onwards

As stage 3 plus:

May start jogging/ sports specific drills



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