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Recuperarea dupa ligamentoplastie

Article written by: DR. ANDREI BOGDAN, Medic primar ortopedie - traumatologie

recuperarea dupa ligamentoplastie

Ligamentoplasty Recovery Protocol (LIA)

After surgery before leaving the operating room, a knee immobilization and an ice pack will be applied to the knee. It is very important that in the first 10 days you do exercises to maintain the extension and keep the ice on your knees. Effective recovery begins the day after surgery.
  • The ice pack will help reduce pain and swelling. Cryotherapy should be used continuously for the first 3-4 days after surgery. Afterwards, the ice should be used for about 30 minutes between physiotherapy sessions.
  • Immobilization in the orthosis helps maintain the extension and must be worn continuously at first, later during walking and sleep, otherwise it can be removed.
In the first 7 days it is very important to work to get your extension back.

Recovery protocol on days 1-8 after surgery:


  • pain and swelling control
  • performing a wide range of movement exercises immediately
  • it also touched and kept the extension completely passive
  • prevention of quadriceps muscle atrophy
  • resumption of walking

What should you do after the surgery:

The period immediately following the surgery should be with the leg raised (prone position and put ice on the knee).

Do not stand for a long time with your foot in a fixed position (lower than the rest of your body), as this will increase the volume of your knee and foot. When you are sitting for a significant period of time, lift your foot on a chair.

Pain control involves the administration of painkillers and anti-inflammatory drugs during hospitalization.

In the first 10 days we advise you not to step on the operated leg with all your weight.

You can take a shower, but the sutures must be protected from water. On the first day and night after a ligamentoplasty, you can expect the bandages to soak in blood. This is normal! We want the stool to drain from the knees into bandages, rather than accumulating in the knees and causing swelling and pain. After 2 days, during which the pain and swelling have improved, the patient will start physical therapy by removing the immobilization every 3 hours:

3 rounds / day of 3 sets of 10 repetitions: isometric contractions of the quadriceps muscle. Each contraction lasts 6 seconds.

3 rounds / day of 8 sets of 10 repetitions: flexion of the thigh on the pelvis at 45-60 degrees. In supine position, with the knee extended, the patient raises the leg to 45-60 degrees and holds the position for 6 seconds. The exercises are performed very gently. After each lift, the patient can relax his muscles for 2-3 seconds.

3-4 rounds / day of 10-15 minutes: full extension. You can regain the extension through 2 types of exercises that you have to alternate. In supine position, place a tight towel under the Achilles tendon (under the ankle), and allow the foot to relax. In a supine position, sit with the lower thigh 1/3 on the edge of the physiotherapy table and relax the pelvic limb. Hyperextension should be avoided.

4-6 rounds / day of 10 minutes of passive flexion and active extension 0-90 degrees: at the edge of the physiotherapy table the foot is lowered passively under the action of gravitational force, and raised by contraction of the quadriceps, helped with the contralateral leg (unoperated ) in both phases.

The patient can passively use an ergonomic bicycle, pedaling only with a healthy foot.

Recovery protocol on days 8-14 after surgery:


  • maintaining full extension
  • psycho-social and family reintegration. The patient must continue to remove the immobilization 4-6 times a day for 10-15 minutes, to continue physiotherapy: isometric contractions, raising the limb to 60 degrees, passive extension, passive extension assisted by ms contraction. quadriceps, passive and active flexion. All exercises are done according to the same program. Their order does not matter, only the number of repetitions and rest times. Each period of the day of physical therapy must include all the exercises listed in the previous program. If the patient has an office job, he is allowed to reintegrate after 14 days. If he has a job that requires intense physical activity, the rest period is 8-12 weeks.

Recovery protocol on days 15-21 after surgery:


  • maintaining full extension
  • reaching a flexion of 100-120 degrees
  • toning the thigh muscles so that the patient can give up immobilization. The patient must continue to remove the immobilization 4-6 times a day for 10-15 minutes, to continue physiotherapy: isometric contractions, raising the limb to 90 degrees, passive extension, passive extension assisted by ms contraction. quadriceps, passive and active flexion. Flexion should be supported with the contralateral foot until it reaches 100-120 degrees.
In addition, the patient should be standing (standing), with the limbs in slightly external rotation, leaning with his hands on a table to have stability and bend his knees slightly. The flexion should be maintained for 6 seconds and the exercise should be performed during 3 sets of 10 repetitions.

The patient will begin to stand on tiptoes: 3 sets of 10 repetitions, 6 seconds each exercise.

The patient will continue to work on the bike as follows:
  • at low intensity
  • resistance will increase after 5-6 weeks postoperatively
  • the time spent on this device will increase progressively from 3 rounds of 5 minutes in the first week to 3 rounds of 20 minutes in the third.
  • after 4 weeks there is no restriction on the time spent on the bike.
After 3 weeks, the patient can give up crutches and immobilization. The car can be driven after 4-6 weeks, if the operated leg is right and after 3 weeks if it is left. If the car has an automatic transmission, in the case of the left leg after 7 days.

Recovery protocol on days 22-40 after surgery:

The patient must continue physical therapy: isometric contractions, raising the limb to 90 degrees, passive extension, active extension assisted by ms contraction. quadriceps, active flexion. The flexion must reach 125 degrees. Practically, the patient must gain all degrees of mobility.

Next you can go to a gym to work with weights under the guidance of a physiotherapy teacher. Swimming is very important at this stage. The patient is allowed after 4 weeks to ride a bike outdoors, without going on level differences.

Jogging is allowed after 12 weeks, and running with a change of direction after 16 weeks.

Sports reintegration is allowed after 9 months.

A weekly medical supervision during the first phase of re-education is desirable because it can improve the results, allowing a more rigorous observance of the recovery program and its adjustment according to each patient, as well as the early detection of possible complications.

NB: All progressions are approximations and should only be used as guidance. Progression will be based on the individual condition of the patient, which is assessed throughout the treatment process.



Pentru ca orice tratament in clinica noastra este bazat pe un diagnostic si se face sub urmarire medicala, pentru evaluarea permanenta a evolutiei.
INFO: Clinica Centrokinetic nu colaboreaza cu Casa Nationala de Asigurari de Sanatate



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