Table 1.

Protection Phase Guidelines and Goals 0-6 weeks post-operative.

Precautions	Goals / Criteria to advance	Interventions
Full ROM	Active terminal knee extension > = 0 Active flexion to within 10° of opposite knee	Passive tibiofemoral mobilizations (posterior femoral glides, screw home mobilizations) Passive patellofemoral mobilizations (superior/inferior, medial/lateral) Patellar tendon and quadriceps tendon mobilizations (medial/lateral) Manual soft tissue massage (quadriceps, hamstrings, gluteus medius/minimus, gastrocnemius/soleus) Isometric quadriceps activation in terminal extension (building to 5 sets of 1 minute hold)
PWB	Gait without assistive device	Weight bearing progression (medial/lateral weight shifts, posterior/anterior weight shifts) Weaning off assistive device (gradual removal of crutches) Reciprocating stair ascension/descent
	Swelling within 0.5 cm of opposite knee (measured at superior pole of patella, 5 cm and 10 cm proximal to superior pole of patella)	Bike (115° flexion present) Lymphedema massage, distal to proximal Ankle pumps (3 sets of 20 reps, 2-3 times / day)
		Progression from mat muscle activation exercises to upright muscle activation exercises Balance progression (interventions include but are not limited to tandem stance, rhomberg stance, single leg stance, unstable surfaces, eyes opened/eyes closed))

ROM = range of motion. PWB = partial weight bearing