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Rehabilitation After Anterior Cruciate Ligament Injury: Review of Current Literature and Recommendations

  • Sports Injuries and Rehabilitation: Getting Athletes Back to Play (R Gallo, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Anterior cruciate ligament reconstruction (ACLR) is a common surgical procedure with an estimated 120,000 cases performed in the USA each year. Physical therapy plays a critical role in the successful recovery of both surgically and non-surgically managed patients. Interestingly, ACL rehabilitation protocols vary greatly with little consensus among practitioners. Nonetheless, there has been agreement over the last decade to shift from conservative, standardized length protocols to more accelerated, individualized protocols that vary in length and modalities based on patient-specific findings and preferences. This review summarizes the most recent trends, opinions, and modalities in ACL rehabilitation research, with a specific focus on novel methods to treat the specific psychosocial needs of ACL deficient patients.

Recent Findings

We found that new protocols emphasize early weight bearing, open kinetic chain (OKC) exercises, and other alternative modalities such as neuromuscular electrical stimulation and blood flow restriction. We also found a recent trend toward the use of clinical milestones to determine when a patient is ready for the next phase of a “step-up” rehabilitation program. One particularly nascent topic of research is the inclusion of methods to treat the psychosocial impacts of ACL injury, recovery, and the anxiety around return to sport.

Summary

Rehabilitation strategy has become increasingly patient-dependent, and the new modalities being utilized are accelerating patient recovery. Return to sport is a particularly important factor for many ACLR patients, and recovery has an important psychological component that has only recently been addressed in the literature, with positive preliminary findings.

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Authors and Affiliations

  1. Advanced Orthopaedics and Sports Medicine, 450 Sutter St, San Francisco, CA, 94108, USA

    Sarah M. Jenkins, Alvarho Guzman, Brandon B. Gardner, Shane Rayos del Sol, Patrick McGahan & James Chen

  2. University of Hawaii Orthopaedic Surgery Residency, Honolulu, HI, USA

    Stewart A. Bryant

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  1. Sarah M. Jenkins
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Sarah Jenkins, Alvarho Guzman, Brandon Gardner, Stewart Bryant, Shane Rayos del Sol, and Patrick McGahan declare that they have no conflict of interest. James Chen has received personal fees from Arthrex outside of published work.

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Jenkins, S.M., Guzman, A., Gardner, B.B. et al. Rehabilitation After Anterior Cruciate Ligament Injury: Review of Current Literature and Recommendations. Curr Rev Musculoskelet Med 15, 170–179 (2022). https://doi.org/10.1007/s12178-022-09752-9

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