Improving Rehabilitation After ACL ReconstructionMore than any other sports injury, rupture of the anterior cruciate ligament (ACL) in the knee has received a great deal of attention. Athletes can sustain this type of injury and still return to full sports participation. There is a concerted effort among researchers to find the best rehabilitation protocol for the fastest and safest return-to-sports.
There are many different ways to approach the rehabilitation of ACL injuries. Sometimes it is possible to complete a conservative plan of exercise without surgery. This approach is most likely for the less active individual or the patient who did not completely rupture the ligament.
Most of the time, active participants in sports and especially those players with a complete ACL rupture require surgery to reconstruct the ligament. Graft tissue taken from the patellar or hamstring tendons is used to replace the destroyed ligament. Rehab is always necessary after surgery. The goals are to regain motion, strength, and balance. Athletes have the additional goal of eventually returning to full level of sports play.
In some places, early, aggressive rehab is started right away during the recovery process. This is referred to as accelerated rehabilitation. In other practices, bracing is used following surgery. Results or outcomes for both of these treatment interventions are reviewed and summarized in this article. The authors systematically review articles related to ACL rehab and published between 2006 and 2010.
Evidence for other types of treatment currently used in ACL rehabilitation are also reviewed by these authors. For example, level one and level two evidence is presented regarding home-based rehab, vibration training, and proprioception and neuromuscular training.
Here's what you don't need:
The jury is still out on:
Now for what is important:
Systematic reviews like this that summarize current evidence around a topic like rehab after ACL reconstruction are important. They help us see trends over time: what works, what doesn't, and what needs further study. They also help find cost effective ways to speed up recovery and return patients to full function and athletes to full sports participation.
L.M. Kruse, MD, et al. Rehabilitation After Anterior Cruciate Ligament Reconstruction. In The Journal of Bone and Joint Surgery. October 3, 2012. Vol. 94A. No. 19. Pp. 1737-1748.
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