Prevention and Management of Post-operative Complications Following ACL Reconstruction

Abstract

Purpose of Review The goal of this paper is to review the current management and prevention of post-operative complications after anterior cruciate ligament (ACL) reconstruction. Trends in rehabilitation techniques will be presented, in addition to suggestions for interventions and expected milestones in ACL reconstruction recovery. Recent Findings ACL reconstruction protocols have evolved to more of a criterion-based progression rather than a tissuehealing time frame. Given the evolution of ACL surgical reconstruction techniques and rehabilitation protocols, the risk of post-operative complications can arise both early and late in the recovery process. This paper will discuss the role of preventative measures as it applies to the post-operative patient with ACL reconstruction. Summary Short-term complications following ACL reconstruction include infection and deficits to knee motion and strength, whereas long-term complications include secondary ACL injury to either the involved or contralateral knee and lack of ability to return to high-level sports following this procedure. Future research should continue to address the multifactorial causes of secondary ACL injury and limited ability of patients to return to high level activities.

Accelerated Rehabilitation For Football Players Following Acl Reconstruction

“…Typical post-operative ACLR and rehabilitation protocols stages include: an early post-operative phase, which focuses on addressing knee range of motion (ROM) deficits, initiating knee strength and control, minimizing pain and effusion, and normalizing gait; a strengthening and neuromuscular control phase, which includes the progression of lower extremity functional strength, and enhancement of balance and neuromuscular control; an advanced strengthening phase, which progresses the patient into plyometrics, agility activities, running and early sport-specific training; and with a final phase focusing on continued strengthening and neuromuscular control with emphasis towards return to sport activities (Eckenrode et al, 2017).…”

“…Wright et al, (2015) recommends initiated open chain quadriceps exercises from 6 weeks. Strength deficits are a common complication following ACLR and rehabilitation should focus on this; regaining strength throughout the entire post-operative course of care (Eckenrode, et al, 2017).The duration by which an athlete is able to advance in his or her programme is extremely variable and dependent on the extent of the injury, the time devoted for training and rehabilitation as well as constitutional variations, so time-based criteria are therefore questionable not only to define the time of the final comeback, but also to progress to the next level of rehabilitation (Petersen et al, 2017).…”

“…At present, the rehabilitation programs are more aggressive and support the return of athletes to sports activities faster. It is important to consider the goals of the patient throughout the rehabilitation process in order to incorporate specific functional and sport-specific activities as appropriate (Eckenrode, Carey, Sennett, & Zgonis, 2017). The previously crossed ligament along with the thigh muscles and the other ligaments are designed to provide the necessary stability in the knee joint.…”

Integrating a Potentiometer into a Knee Brace Shows High Potential for Continuous Knee Motion Monitoring

“…In addition to their acute impact on health, knee ligament injuries are potential risk factors for later knee osteoarthritis [ 2 ] and chronic balance impairments [ 3 ]. Evidence suggests that early-stage recovery is important for restoration of joint stability and prevention of knee disabilities in late life [ 4 , 5 , 6 ]. Sagittal knee range of motion (ROM), in particular, is frequently impaired after knee ligament injury and can impact the execution of daily activities both in the short- and long-term [ 4 ].…”

“…Evidence suggests that early-stage recovery is important for restoration of joint stability and prevention of knee disabilities in late life [ 4 , 5 , 6 ]. Sagittal knee range of motion (ROM), in particular, is frequently impaired after knee ligament injury and can impact the execution of daily activities both in the short- and long-term [ 4 ]. Its continuous monitoring during the early phase of rehabilitation could allow physicians and clinicians to better identify individual therapeutic needs for patients.…”