A Systematic Review of Anterior Cruciate Ligament Reconstruction Rehabilitation –Part I: Continuous Passive Motion, Early Weight Bearing, Postoperative Bracing, and Home-Based Rehabilitation

Abstract

Anterior cruciate ligament (ACL) reconstruction is a common surgical knee procedure that requires intensive postoperative rehabilitation by the patient. A variety of randomized controlled trials have investigated aspects of ACL reconstruction rehabilitation. A systematic review of English language level 1 and 2 studies identified 54 appropriate randomized controlled trials of ACL rehabilitation. Topics discussed in this part of the article include continuous passive motion, early weight bearing in motion, postoperative bracing, and home-based rehabilitation. [J Knee Surg. 2008;21:217-224.]

Changes in Involved and Uninvolved Limb Function During Rehabilitation After Anterior Cruciate Ligament Reconstruction

“…20,26 To improve these outcomes, rehabilitation regimens are becoming increasingly evidence-based, and many have incorporated functional testing protocols. 8,14,24,28,35,38 However, the literature has not yet established a relationship between SFT performance and successful return to play or lower reinjury rates. 4 While one previous study found that ACL reconstruction patients with LSI higher than 85% in the single-leg hop and crossover triple hop were more likely to attempt return to play, it did not examine the success of those attempts.…”

Survey Study of Members of the Canadian Orthopaedic Association on the Natural History and Treatment of Anterior Cruciate Ligament Injury

“…14 Meanwhile, several studies and reviews conclude that there is no scientific evidence that pain, range of motion, graft stability, or protection from subsequent injury was affected by brace use. [15][16][17][18] A focus of ongoing research in other centers on bracing is aimed at identifying particular groups that may benefit from bracing beyond typical use, for example, skiers. 19 As more well-designed studies are conducted in this area, we may see increased consensus on bracing use.…”

Rehabilitation After Anterior Cruciate Ligament Reconstruction

“…Four studies included in the previous systematic reviews had evaluated home-based compared with outpatient physical therapy for rehabilitation after ACL reconstruction 1,2 . Despite flaws in reporting and study design that resulted in biases, the studies indicated that a motivated patient could obtain reasonable results with minimally supervised home-based rehabilitation.…”