Current concepts in anterior cruciate ligament rehabilitation

Eight years of experience in performing only bone-patellar tendon-bone autograft reconstructions of the anterior cruciate ligament (ACL) are presented, with an emphasis on an accelerated post-operative rehabilitation protocol. Past patient non-compliance to previously established protocols still yielded very acceptable results that demanded further investigation. Gradually we developed a three-phase rehabilitation plan that is implemented after surgical correction of ACL deficiencies. The first phase (zero to two weeks) focuses primarily on wound healing, full extension, control of swelling, and leg control. The second phase (two to five weeks) involves increasing flexion, developing a functional gait, and resuming activities of daily living. The third phase (greater than 5 weeks) identifies a safe return to competitive athletics. This protocol evolved with close observation of approximately 1,000 reconstructions and has been used on the last 650 patients since January 1987. A decreased postoperative morbidity was noted without a compromised clinical stability.