Rehabilitation following Anterior Cruciate Ligament Reconstruction: A Comparison of Traditional and Accelerated Approaches

Rehabilitation following Anterior Cruciate Ligament (ACL) reconstruction has become an area of controversy in recent years. Most clinicians have used the traditional rehabilitation protocols which correlate mobility, weightbearing, and strength training with the bio-mechanical and surgical constraints of graft fixation and healing. However, a trend towards the use of accelerated protocols is more evident today. The accelerated approach stresses activity and weightbearing in the early periods of the rehabilitation process following the reconstructive surgery. The proponents of the accelerated protocol believe that earlier activity will enhance the healing of the graft without causing an increase in knee instability. The purpose of this independent study is to review the literature regarding the traditional and accelerated rehabilitation approaches for ACL reconstruction in an effort to explain and compare the two, and identify advantages and disadvantages of each approach. In addition, this review investigates: the minimum healing requirements which should be met before initiating rehabilitation activity, what surgical considerations are important, and if there is a preferred method of strength training following ACL reconstruction. The conclusion of this review supports the accelerated approach to rehabilitation as the best choice for patients following ACL reconstruction. This information hopefully can be of aid for physical therapists in establishing treatment programs for these patients