Surgery Rehab

ACL reconstruction is a surgery to replace a torn anterior cruciate ligament (ACL) that removes the ACL and replaces it with tissue from your patella tendon, quadriceps tendon, hamstring tendon, or a tendon harvested from a cadaver. The ACL is a ligament that connects your thighbone to your shin bone and is responsible for preventing excessive forward movement of your shin bone. The ACL is commonly torn in sports that require quick stopping, cutting, lateral movements, and jumping such as football, soccer, skiing, and basketball.

Post-operation rehabilitation is generally 6-9 months that progresses the patient from performing everyday tasks such as walking and stairs to running at jumping by the 24 week mark.

Besides ACL reconstruction, other common knee surgeries include meniscus removal or meniscectomy, meniscus repairs, medial patellofemoral ligament reconstruction or chronic knee cap dislocation, patella tendon or quadriceps tendon repair, medial collateral ligament repairs, and posterior collateral ligament repairs. Each surgery has a specific protocol that a physical therapist will progress each patient through and generally involves restoring range of motion and strength of the muscles surrounding the knee including the quadriceps, hamstring, hips, and calf muscles.

Total hip replacement surgery is a surgery that replaces the existing hip bones with prosthetic parts usually made of metal, ceramic, and polyethylene parts. Patients that seek a total hip replacement surgery usually have been diagnosed with hip osteoarthritis, rheumatoid arthritis, avascular necrosis, a femur fracture, or arthritis after trauma to the hip. There are multiple approaches to a total hip replacement but are commonly either an anterior, posterior, or lateral hip approach with anterior or posterior approach being most common. Post-operative rehabilitation usually focuses on range of motion and strength with gradual return to functional activities that meets the patient’s needs.

The most common surgery for the shoulder is a rotator cuff repair where tendons involving the involving the supraspinatus, infraspinatus, teres minor and subscapularis are repairs. Rotator cuff tears are classified into one of 4 categories: small, medium, large/massive, and subscapularis based on which tendons were affected and the size of the tear. Post-surgical rehabilitation can vary but generally requires a 6-week period of general protection with gentle range of motion as directed by a physical therapist. Active range of motion and strength is slowly introduced and progressed for the next 18-20 weeks depending on the patient’s goals and functional activity.

Lumbar spine surgeries are usually indicated when there is abnormal motion of specific lumbar vertebral joints, compression of nerves causing pain to radiate into the lower extremities, or disruption of the disc structures that separate individual bones in the lumbar spine. While there are many lumbar spine surgeries, they can be grouped into decompression surgeries or stabilization surgeries. Decompression surgeries such as a discectomy or laminectomy aim to limit radiating nerve symptoms by removing structures such as the disc or parts of the vertebrae. Stabilization surgeries such as spine fusions aim to limit motion between two vertebras and are indicated in lumbar spine injuries such as spondylolisthesis. Post-surgery rehabilitation usually involves a period up to 6 weeks where motion is limited. Strength and range of motion is then generally progressed in 4 to 6 week blocks depending on the patient’s functional goals.