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Rehabilitation programs have progressed alongside surgical advances in anterior cruciate ligament reconstruction. A perioperative program has been successfully used at our clinic for more than 10 years to reduce postoperative complications and return patients to activity safely and quickly. The four-phase program starts at the time of injury and preoperatively includes aggressive swelling reduction, hyperextension exercises, gait training, and mental preparation. Goals after surgery are to control swelling while regaining full knee range of motion. After quadriceps strengthening goals are reached, patients can shift to sport-specific exercises.

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In this study, we sought to determine if a significant change in patellar height occurs after autogenous patellar tendon anterior cruciate ligament (ACL) reconstruction at our clinic. In a series of 71 patients (52 males and 18 females; average age: 22 years; range: 12 to 41) randomly selected, all had undergone an identical autogenous patellar tendon ACL reconstruction, by the same surgeon, and followed the same postoperative accelerated rehabilitation program. All patients bad standardized preoperative and postoperative lateral knee radiographs. The patellar tendon length as well as the patellar height and ratio of Blackburne and Peel were measured by the same person for all subjects. The length of the patellar tendon shortened by an average of 0.4 mm (range: 6% lengthening to 12% shortening) which is less than 1% and not statistically significant (P=.068). The Blackburne and Peel ratio for patellar height decreased by 1%, which was also not statistically significant (P=.060). The evidence obtained from this study indicated no significant change in patellar height after autogenous patellar tendon ACL reconstruction combined with postoperative accelerated rehabilitation and no correlations with postoperative complications, secondary surgeries, timing of surgery, age, or anterior knee symptoms.