Subjective: Patient reports compliance and can demonstrate prescribed exercises given in HEP during five weeks before surgery. Patient is currently complaining of knee pain following ACL reconstruction on 12/20/96.
Objective: Patient ambulates WBAT on right lower extremity with crutches. Moderate swelling noted. Right knee AROM limited. Flexion: 99°. Extension: - 4°. Strength not tested at this time secondary to increased pain.
Assessment: Patient is a young active female presenting with decreased strength and ROM of right knee. Patient has had previous left knee surgery to repair a ruptured bursa, but appears motivated to return to sport. Expect patient to progress with physical therapy intervention and extensive patient education.
- Decreased ROM
- Decreased strength
- Increased edema
- Dependent gait
- Decreased neuromuscular control
- Increased pain
Short term goals (6 weeks):
- Patient will be independent with HEP.
- Patient will increase right knee AROM to at least 0 to 125°.
- Patient will ambulate full weight bearing (FWB) on the right with no assistive device (AD).
Long term goal (24 weeks):
Patient will return back to sport specific activities with no pain.
Plan: Physical therapy intervention will include upright bike initially followed by passive range of motion (PROM) to right knee. Patient will then be progressed into an ACL rehab protocol. Functional electrical stimulation will be used to assist the patient initiate an active quadriceps contraction into full extension. The patient will also be instructed in gait training so that she may ambulate independently. Application of a cold pack and electrical stimulation with right knee elevated will follow each PT session to minimize pain and swelling. Patient will be seen three times per week for four weeks, with a re-evaluation to be scheduled in four to five weeks.