Rehabilitation after hamstring anterior cruciate ligament reconstruction

A prospective comparative study was conducted involving 62 patients to determine the effects and limits of accelerated rehabilitation on clinical outcome. The study focused on whether aggressive rehabilitation after anterior cruciate ligament reconstruction with the doubled semitendinosus and gracilis tendon autograft results in stretching the graft. Thirty patients had postoperative rehabilitation according to the current conservative protocol, and 32 patients had rehabilitation using an accelerated regime. Each patient was evaluated subjectively and objectively 36 months or more after surgery. Concerning the side-to-side difference in the anterior laxity, 87% of the patients in the conservative rehabilitation group had 3 mm or less and 80% of the patients in the accelerated rehabilitation group had the same acceptable laxity. There was no significant difference between the two groups. Muscle torque was restored significantly earlier in the patients in the accelerated rehabilitation group than in the patients in the conservative rehabilitation group. Nine months after surgery, however, there were no significant differences in the torque between the two groups. Accelerated rehabilitation significantly increased the incidence of knee effusion during rehabilitation. This study showed that acceleration of postoperative rehabilitation could rapidly restore muscle strength without significantly compromising graft stability in anterior cruciate ligament reconstruction with the doubled hamstring tendon autograft. However, this study also showed that acceleration significantly increases the incidence of synovitis. Acceleration of postoperative rehabilitation has advantages and disadvantages for clinical outcome after anterior cruciate ligament reconstruction.