Phase I: Early Recovery and Motion (0–2 Weeks)

Precautions:

• Weight bearing as tolerated with or without crutches.

• Avoid prolonged standing or walking if swelling increases.

• Avoid kneeling and deep squatting.

Therapy:

• Early knee range of motion exercises as tolerated.

• Quadriceps activation (e.g. quadriceps sets, straight leg raises).

• Gait re-education with walking aids as required.

• Oedema control and pain management.

Criteria to Progress:

• Pain and swelling controlled.

• Independent ambulation with normalising gait.

Phase II: Strengthening and Functional Recovery (2–6 Weeks)

Precautions:

• Avoid deep squatting, pivoting, and twisting activities.

Therapy:

• Progress knee range of motion to full.

• Closed-chain strengthening of quadriceps and hamstrings.

• Balance and proprioception exercises.

• Cardiovascular conditioning (e.g. cycling).

Criteria to Progress:

• Full or near full knee range of motion.

• Minimal pain during daily activities.

Phase III: Advanced Strengthening Phase (6–12 Weeks)

Precautions:

• Avoid high-impact activities until strength and control improve.

Therapy:

• Progressive strengthening of lower limb musculature.

• Dynamic balance and agility exercises.

• Gradual introduction of impact activities as tolerated.

Criteria to Progress:

• Good strength and neuromuscular control.

• No effusion with increased activity.

Phase IV: Return to Activity (3–6 Months)

Therapy:

• Sport- and work-specific functional rehabilitation.

• Gradual return to running, pivoting, and impact sports.

Criteria to Discharge:

• Full, pain-free knee range of motion.

• No swelling or instability.

• Strength and function appropriate for activity demands.

General Recommendations

Work:

• Desk-based work may resume after 1–2 weeks.

• Manual labour is typically deferred until 4–6 weeks depending on job demands.

Driving:

• It is important that you are medically fit to return to driving and you feel safe to control the vehicle and take evasive action if needed.

• In general, for left knee surgeries in vehicles with automatic transmission, return to driving may be sooner.

Sports and Leisure:

• Low-impact activities may resume from 2-4 weeks.

• Running, jumping, and contact sports are usually delayed until after 6–12 weeks with surgeon clearance.

Thromboprophylaxis

For this procedure, routine postoperative pharmacological thromboprophylaxis is not generally required. In selected cases, A/Prof Ernstbrunner and his medical team may consider prescribing thromboprophylaxis based on the individual patient’s risk factors and comorbidities.

Disclaimer: This protocol is intended as a general rehabilitation guide only. Rehabilitation progression should always be individualised and may be modified by A/Prof Ernstbrunner and the treating rehabilitation team based on the patient’s clinical progress, surgical findings, and individual circumstances.