Cranial Cruciate Ligament Reconstruction
Post Operative Rehabilitation For Conventional Repairs
Micki Hedgepeth Fox, P.T
Week 1 (days 2-7) [ IF NO BANDAGE ]
1. Apply a cold pack or ice pack (bag of frozen peas works well) to the knee for 10-20 minutes at a time. Time between cold treatments at least 1 hour. Apply 3 or 4 times per day for the first week. Don’t place directly on skin and avoid getting incision wet. Try using a thin layer like a pillowcase between cold pack and skin. Cold/ice treatments help reduce pain by reducing inflammation and swelling.
2. Gently massage leg for 5 to 10 minutes as your pet tolerates.
3. Move the leg through its full range of motion (bend knee and ankle up, then stretch knee out straight). Do this 3 times per day.
4. Your pet should be confined to leash walks only. Initially, he/she will only be able to take a short trip outside to use the bathroom. By the end of the week, he/she may be up to 3-5 minutes. Avoid inclines or declines and icy conditions. Also be aware of slippery floors (i.e. hardwood floors). Your dog may or may not be putting weight on his/her leg at this point. If they are, it is ok and actually is good for them. Beware as time passes and your pet begins to feel better, he/she does not realize your investment in repairing his/her leg. Restrict activity - no jumping or rough play, no standing on just the back legs, no stairs, no jumping on or off furniture. Control out of doors is best managed by use of a leash.
Week 2 [ AFTER THE BANDAGE IS REMOVED ]
1. You can stop using cold and switch to warm compresses. If incision is still open, avoid getting it wet. You can make a warm compress by microwaving a wet washcloth or dishtowel in a plastic bag (don’t fully seal bag) for 30 seconds. Test on yourself before placing on animal as they can get really hot. Leave on 5-10 minutes.
2. Continue range of motion exercise 15 to 20 repetitions two to three times daily.
3. Massage leg 5 to 10 minutes as above.
4. Controlled leash walks to continue two to three times per day, gradually increasing up to 10 minutes per outing. (If dog starts to regress by not weight bearing on leg or limping a lot - use your best judgment and reduce the amount of time.)
Week 3 through Week 4
1. Continue with use of warm compresses prior to range of motion for the third to fourth week.
2. Continue range of motion exercises 15-20 repetitions three times a day.
3. Continue leash walking, increasing up to 15 minutes per outing. Avoid inclines and declines and stairs. Restrict activity level ; i.e. no jumping, no running, etc.
4. Start swimming therapy: Swim daily to weekly starting with 5-minute intervals.
1. Continue with range of motion exercise and controlled leash walks.
2. Can start controlled walking on inclines and declines slowly. Do 3 times per day.
3. Can start stairs very slowly and cautiously but continue to minimize use of stairs.
4. When possible, incorporate swimming into pet’s program.
Week 6 through Week 8
1. Continue range of motion exercises and controlled leash walks up to 20 minutes.
2. Incline walking is continued. Increase the speed and the duration of the walk but not the steepness.
3. Continue swimming when possible.
4. Restrictions on activity are still present. No running, jumping, or rough play. Still avoid slippery surfaces.
Week 9 through 4 Months
1. Walks to continue with emphasis on inclines/declines and figure 8's.
2. Passive therapy to continue as needed.
3. Continue swimming.
4. Restrictions on activity are still present. No running, jumping, or rough play. Avoid slippery surfaces.
Week 16 to Week 50
1. Walks to continue as from week 9.
2. Continue swimming.
3. Increase activity; keep on lead. Increase by 5-10 minute intervals.