Rehabilitation for anterior instability of the knee: preliminary report

Anterior instability of the knee and its associated rotatory components is recognized as a common disabling knee problem in athletes and nonathletes. The spectrum of anterior instability begins with injury to the anterior cruciate ligament as an isolated event or as part of an injury complex. Within the genera classification of anterior instability are straight, anteromedial, anterolateral, and combined. The type of instability is recognized in relation to the relative movement of the tibia on the femur and the rotational position of the tibia relative to the femur when an anteriorly directed force is applied to the tibia. The status of the static stabilizers of the knee dictates the type of instability. Treatment following anterior cruciate injury depends upon the extent of injury. Where significant disability and instability exist, reconstructive surgery utilizing intracapsular and/or extracapsular repairs can be performed. Rehabilitation begins at the time of injury and continues throughout life. The rehabilitation program should attempt to: 1) minimize risks of reinjury; 2) educate the patient; 3) reinforce stability with exercise based on biomechanical principles; 4) prevent or prolong the subsequent onset of degenerative changes; and 5) reinstate the previous performance level. J Orthop Sports Phys Ther 1982;3(3):121-128.