ACL Reconstruction and Stationary Bike

What are pre-operative goals prior to ACL surgery

Restore full knee ROM (especially extension)
Prevent atrophy and weakness
Address strength and flexibility of the hip and ankle

What is a contraindication to ACL surgery in young patients

Lack of skeletal maturity

How soon should you start post-operative exercises

Immediately on the first day

ACL revascularization timeline

The tendon graft goes through a necrotizing process in the first 2-3 weeks

During the ACL graft revascularization period how should exercise progression be handled

Cautiously due to weakness of the graft

What has a faster healing time frame: Bone to Bone or Soft tissue to Bone

Bone to Bone

What are precautions during post-operative ACL exercises

Knee flexor strengthening for hamstring tendon autografts
Knee extensor strengthening for patellar tendon autografts
No OKC knee extension in short sitting (long arc quad exercises)

What type of exercises are preferred post-operative ACLR

CKC rehabilitation strategies
But avoid CKC quadricep strengthening between 60 and 90 degrees of flexion

What type of bracing is used immediately post-operative ACLR

Hinged orthosis with locking mechanism (up to 6 weeks)

When should the brace be locked during the first 6 weeks post-operation

When ambulating

When can the brace be unlocked during the first 6 weeks post-operation

With exercises when ROM is prescribed

When are functional braces used and what are the benefits

Used during advanced rehab (11-24 weeks)
Beneficial for those in high-demand sports and reduces anterior translation

What effect does a high seat height on a stationary bike have

Increased knee extension
Decreased knee displacement
Increased quadricep work
Increased stress on ITB

What effect does a low seat height on a stationary bike have

Increased knee flexion
Decreased performance
Increased stress on knee
Increased hamstring work

What effect does a forward saddle position on a stationary bike have

Increased rectus femoris work
Increased patellofemoral stress

What effect does a backward saddle position on a stationary bike have

Increased hamstring work
Decreased stress on knee

What effect does an internally rotated pedal on a stationary bike have

Creates lateral stress on the knee → causes IR of the tibia and increases valgus force on the knee and increase stress on the ITB
Medial stretch and lateral compression (stress)