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Related Experiment Video

Updated: May 15, 2026

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction

Published on: March 1, 2024

Cross-exercise on quadriceps deficit after ACL reconstruction.

Maria Papandreou¹, Evdokia Billis, George Papathanasiou

¹Department of Physiotherapy, Technological Education Institute of Athens, Faculty of Health Sciences and Caring Professions, Athens, Greece. mpapand@teiath.gr

The Journal of Knee Surgery

|January 5, 2013

Summary

Cross-eccentric exercise (CEE) significantly improved quadriceps strength deficit (QD) in anterior cruciate ligament (ACL) reconstructed knees. Early-stage rehabilitation using CEE three or five times weekly enhances recovery.

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Area of Science:

Orthopedics
Sports Medicine
Rehabilitation Science

Background:

Quadriceps strength deficit (QD) is a common issue after anterior cruciate ligament (ACL) reconstruction.
Existing ACL rehabilitation protocols lack specific strategies targeting contralateral quadriceps strength (QS).
The efficacy of cross-eccentric exercise (CEE) for improving QD in early-stage ACL rehabilitation is not well-established.

Purpose of the Study:

To assess the impact of cross-eccentric exercise (CEE) on quadriceps strength deficit (QD) in ACL-reconstructed knees.
To investigate the effects of CEE frequency (3 or 5 times per week) on QD during early-stage rehabilitation.

Main Methods:

Forty-two ACL-reconstructed patients were randomized into three groups: two experimental (receiving CEE) and one control.

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Last Updated: May 15, 2026

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction

Published on: March 1, 2024

Experimental groups performed CEE on their uninjured knees 3 or 5 times per week for 8 weeks.

Quadriceps strength (QS) was measured using isokinetic/isometric testing before and after the 8-week intervention.

Main Results:

A significant improvement in quadriceps strength deficit (QD) was observed in the ACL-reconstructed knees post-CEE intervention.
Both CEE frequencies (3 days/week and 5 days/week) demonstrated statistically significant improvements in QD.
The control group showed no significant changes in QD, highlighting the specific effect of CEE.

Conclusions:

Cross-eccentric exercise (CEE), when added to standard rehabilitation, effectively improves quadriceps strength deficit (QD) in the early phase after ACL reconstruction.
Implementing CEE 3-5 times per week offers a viable strategy to enhance quadriceps recovery and address strength imbalances post-surgery.