Physiotherapy Protocol

ARTHROSCOPY

An arthroscopy is a minimally invasive (‘Key hole”) operation to repair or investigate the integrity of your knee joint. Your surgeon examines the joint with an arthroscope (joint camera) while making repairs if needed through a small incision.

Phase 1: (0-2 weeks)

Goals:

  • Control swelling
  • Achieve normal gait and adequate weight bearing status
  • Dressing care

Guidelines:

  • Standing: Double leg to single leg calf raises. E.g. 4×12 slow and controlled
  • Lying: Heel slides: Sliding heel up the bed/floor to buttock, hold stretch and slowly release. Repeat 15 times with 3 sec holds.
  • Inner range quads: Rolled up towel/pillow under knee, lift heel off bed/floor, hold, lower and repeat. 5×10 times
  • Soft tissue therapy for swelling management
  • Sitting: VMO exercises in sitting: Turnout foot, small bend at the knee, lift leg from hip slightly, having inside of foot facing up, hold, lower, gently extend knee, hover and repeat: E.g. 4×8 slow and controlled. Feeling a fatigue in the medial aspect of Quadriceps
  • Ice – Intermittently
  • Elevation

Phase 2: (2-4 weeks)

Goals:

  • Regain strength
  • Achieve normal joint range of motion and gait

Guidelines:

  • Standing: Proprioceptive exercises: E.g. single leg balancing on a firm/stable surface to a soft/unstable surface. Progress to toe taps with uninvolved leg out to side, backwards and in front.
  • Stretching: Hamstrings and calf muscles
  • Lying: Bridging: Double leg to single leg, slow and controlled
  • Soft tissue therapy for swelling and scar management
  • Stationary bike: low resistance to start. Gradually progress time and resistance as tolerated
  • Functional walking on varied surfaces

Phase 3: (4 weeks onwards)

Goals:

  • Return to functional status as indicated

Guidelines:

  • Slow progression to jogging. E.g. on grass, flat surface, interval style then progress to hills
  • Swimming
  • Stationary bike: increasing resistance
  • Gym program: E.g. Double leg press (0-60 degrees), progressive resistance as tolerated
  • Dynamic Proprioception: focusing on landing stability, deceleration exercises and multi-directional strengthening. E.g. hopping forwards, backwards, sideways, varying surfaces etc