Current Australian trends in rehabilitation following anterior cruciate ligament reconstruction

This study documented the current approaches to rehabilitation following anterior cruciate ligament (ACL) reconstruction by Australian orthopaedic surgeons. A two-page questionnaire was mailed to the 40 members of the Australian Knee Society to obtain information regarding (1) pre-operative requirements; (2) immediate post-operative requirements; and (3) the timing of the introduction of rehabilitation phases and return to sport following ACL reconstruction. The response rate of practising surgeons was 95%. Twenty-two surgeons (61%) regularly performed both hamstring tendon (HS) and patellar tendon (PT) ACL reconstruction. Eighty-three percent had a standard rehabilitation protocol, and of these, 23% had separate protocols for the two graft types. There were no significant differences between the responses for the two graft types for any question. Approximately three-quarters of surgeons (HS: 75%, PT: 78%) had specific pre-operative requirements. Most surgeons (HS: 96%, PT: 93%) had specific post-operative requirements. Physiotherapy was routinely used by 96% and 93% of surgeons for HS and PT grafts, respectively, commencing at a mean of 2 weeks post-operatively for HS grafts and a mean of 1.5 weeks for PT grafts. Progression through rehabilitation and the timing of return to various levels of sporting activity was similar for both graft types. Few surgeons used strength testing (HS: 25%, PT: 23%) or knee arthrometry (HS: 22%, PT: 17%) prior to return to sport and the use of a brace was rarely recommended for return to sport (HS: 7%, PT: 3%). The results of this survey indicate little variation in the post-operative management of HS and PT ACL reconstruction among members of the Australian Knee Society. Future research should, however, be directed towards the rate of progression through rehabilitation, as this was shown to be more conservative than other recent reports.