Abstract
This chapter reviews the scientific principles and concepts for the development of an ACL reconstruction postoperative rehabilitation program. The exercises and modalities used in each phase of the program are presented, along with signs and symptoms to recognize and treat to prevent a complication such as loss of knee motion. Criteria are provided to advance the patient through the program in a manner which is safe to the healing graft and responsive to the patient’s final activity level goals. Advanced neuromuscular retraining is advocated for patients who desire to return to high-risk activities such as soccer and basketball. Criteria for final release to unrestricted athletics are provided.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ait Si Selmi T, Fithian D, Neyret P (2006) The evolution of osteoarthritis in 103 patients with ACL reconstruction at 17 years follow-up. Knee 13(5):353–358
Barber-Westin SD, Heckmann TP, Noyes FR (2009) Scientific basis of rehabilitation after anterior cruciate ligament autogenous reconstruction. In: Noyes FR (ed) Noyes’ knee disorders: surgery, rehabilitation, clinical outcomes. Saunders, Philadelphia, pp 268–305
Barber-Westin SD, Noyes FR (2011) Objective criteria for return to athletics after anterior cruciate ligament reconstruction and subsequent reinjury rates: a systematic review. Phys Sportsmed 39(3):100–110
Barber-Westin SD, Noyes FR (2011) Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. Arthroscopy 27(12):1697–1705
Barrett DS (1991) Proprioception and function after anterior cruciate reconstruction. J Bone Joint Surg Br 73(5):833–837
Beard DJ, Kyberd PJ, Fergusson CM (1993) Proprioception after rupture of the anterior cruciate ligament. An objective indication of the need for surgery? J Bone Joint Surg Br 75(2):311–315
Beard DJ, Dodd CAF, Trundle HR et al (1994) Proprioception enhancement for anterior cruciate ligament deficiency. A prospective randomised trial of two physiotherapy regimes. J Bone Joint Surg Br 76(4):654–659
Crossley KM, Zhang WJ, Schache AG et al (2011) Performance on the single-leg squat task indicates hip abductor muscle function. Am J Sports Med 39(4):866–873
Deehan DJ, Salmon LJ, Webb VJ et al (2000) Endoscopic reconstruction of the anterior cruciate ligament with an ipsilateral patellar tendon autograft. J Bone Joint Surg Br 82(7):984–991
Drogset JO, Grontvedt T, Robak OR et al (2006) A sixteen-year follow-up of three operative techniques for the treatment of acute ruptures of the anterior cruciate ligament. J Bone Joint Surg Am 88(5):944–952
Fischer-Rasmussen T, Jensen PE (2000) Proprioceptive sensitivity and performance in anterior cruciate ligament-deficient knee joints. Scand J Med Sci Sports 10(2):85–89
Fitzgerald GK, Axe MJ, Snyder-Mackler L (2000) The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physical active individuals. Phys Ther 80(2):128–140
Gao B, Zheng NN (2010) Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and -reconstructed knees during walking. Clin Biomech (Bristol, Avon) 25(3):222–229
Heckmann TP, Noyes FR, Barber-Westin SD (2009) Rehabilitation of primary and revision anterior cruciate ligament reconstructions. In: Noyes FR (ed) Noyes’ knee disorders: surgery, rehabilitation, clinical outcomes. Saunders, Philadelphia, pp 306–336
Hui C, Salmon LJ, Kok A et al (2011) Fifteen-year outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft for “isolated” anterior cruciate ligament tear. Am J Sports Med 39(1):89–98
Ihara H, Nakayama A (1986) Dynamic joint control training for knee ligament injuries. Am J Sports Med 14(4):309–315
Ingersoll CD, Grindstaff TL, Pietrosimone BG et al (2008) Neuromuscular consequences of anterior cruciate ligament injury. Clin Sports Med 27(3):383–404, vii
Keays SL, Bullock-Saxton JE, Keays AC et al (2007) A 6-year follow-up of the effect of graft site on strength, stability, range of motion, function, and joint degeneration after anterior cruciate ligament reconstruction: patellar tendon versus semitendinosus and Gracilis tendon graft. Am J Sports Med 35(5):729–739
Lephart S, Kocher MS, Fu F et al (1992) Proprioception following anterior cruciate ligament reconstruction. J Sport Rehabil 1:188–196
Liu-Ambrose T, Taunton JE, MacIntyre D et al (2003) The effects of proprioceptive or strength training on the neuromuscular function of the ACL reconstructed knee: a randomized clinical trial. Scand J Med Sci Sports 13(2):115–123
MacDonald PB, Heeden D, Pacin O et al (1996) Proprioception in anterior cruciate ligament-deficient and reconstructed knees. Am J Sports Med 24(6):774–778
Madhavan S, Shields RK (2011) Neuromuscular responses in individuals with anterior cruciate ligament repair. Clin Neurophysiol 122(5):997–1004
Myklebust G, Holm I, Maehlum S et al (2003) Clinical, functional, and radiologic outcome in team handball players 6 to 11 years after anterior cruciate ligament injury: a follow-up study. Am J Sports Med 31(6):981–989
Nakata K, Shino K, Horibe S et al (2008) Arthroscopic anterior cruciate ligament reconstruction using fresh-frozen bone plug-free allogeneic tendons: 10-year follow-up. Arthroscopy 24(3):285–291
Noyes FR, Barber-Westin SD (2009) Prevention and treatment of knee arthrofibrosis. In: Noyes FR (ed) Noyes’ knee disorders: surgery, rehabilitation, clinical outcomes. Saunders, Philadelphia, pp 1053–1095
Noyes FR, Barber-Westin SD (2009) Anterior cruciate ligament primary and revision reconstruction: diagnosis, operative techniques, and clinical outcomes. In: Noyes FR (ed) Noyes’ knee disorders: surgery, rehabilitation, clinical outcomes. Saunders, Philadelphia, pp 140–228
Orishimo KF, Kremenic IJ, Mullaney MJ et al (2010) Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18(11):1587–1593
Pinczewski LA, Lyman J, Salmon LJ et al (2007) A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial. Am J Sports Med 35(4):564–574
Risberg MA, Mork M, Jenssen HK et al (2001) Design and implementation of a neuromuscular training program following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 31(11):620–631
Risberg MA, Holm I (2009) The long-term effect of 2 postoperative rehabilitation programs after anterior cruciate ligament reconstruction: a randomized controlled clinical trial with 2 years of follow-up. Am J Sports Med 37(10):1958–1966
Roe J, Pinczewski LA, Russell VJ et al (2005) A 7-year follow-up of patellar tendon and hamstring tendon grafts for arthroscopic anterior cruciate ligament reconstruction: differences and similarities. Am J Sports Med 33(9):1337–1345
Sajovic M, Strahovnik A, Komadina R et al (2008) The effect of graft choice on functional outcome in anterior cruciate ligament reconstruction. Int Orthop 32(4):473–478
Salmon LJ, Russell VJ, Refshauge K et al (2006) Long-term outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft: minimum 13-year review. Am J Sports Med 34(5):721–732
Schultz RA, Miller DC, Kerr CS et al (1984) Mechanoreceptors in human cruciate ligaments. A histological study. J Bone Joint Surg Am 66(7):1072–1076
Schutte MJ, Dabezies EJ, Zimny ML et al (1987) Neural anatomy of the human anterior cruciate ligament. J Bone Joint Surg Am 69(2):243–247
Shelbourne KD, Gray T, Haro M (2009) Incidence of subsequent injury to either knee within 5 years after anterior cruciate ligament reconstruction with patellar tendon autograft. Am J Sports Med 37(2):246–251
Webster KA, Gribble PA (2010) Time to stabilization of anterior cruciate ligament-reconstructed versus healthy knees in National Collegiate Athletic Association Division I female athletes. J Athl Train 45(6):580–585
Wilk KE, Chmielewski TL (2009) Neuromuscular retraining after anterior cruciate ligament reconstruction. In: Noyes FR (ed) Noyes knee disorders: surgery, rehabilitation, clinical outcomes. Saunders, Philadelphia, pp 337–356
Wojtys EM, Huston LJ (1994) Neuromuscular performance in normal and anterior cruciate ligament-deficient lower extremities. Am J Sports Med 22(1):89–104
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Chap19 (MP4 180,656 KB)
Rights and permissions
Copyright information
© 2012 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Heckmann, T.P., Noyes, F.R., Barber-Westin, S.D. (2012). Rehabilitation After ACL Reconstruction. In: Noyes, F., Barber-Westin, S. (eds) ACL Injuries in the Female Athlete. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32592-2_19
Download citation
DOI: https://doi.org/10.1007/978-3-642-32592-2_19
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-32591-5
Online ISBN: 978-3-642-32592-2
eBook Packages: MedicineMedicine (R0)