Evidence Summary for Early-Stage Rehabilitation After Anterior Cruciate Ligament Reconstruction

To retrieve, evaluate, and summarize the best evidence for early-stage (and pre-operative) rehabilitation in patients with anterior cruciate ligament reconstruction, thereby providing an evidence-based foundation for the future development of early rehabilitation protocols.

Based on the "6S" evidence-based model, we systematically searched domestic and international guideline websites, websites of relevant professional societies and Chinese and international databases. Sources included clinical decisions, guidelines, systematic reviews, evidence summaries, expert consensuses, and randomized controlled trials. The search covered all records from the time of establishment to January 2026. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence.

A total of 18 studies were included, consisting of 2 clinical decisions, 3 guidelines, 3 systematic reviews, 3 expert consensuses, 2 evidence summaries, and 5 randomized controlled trials. Based on the Capability, Opportunity, Motivation-Behaviour (COM-B) model, we extracted evidence and summarized a total of 27 best-evidence items across the following eight aspects: definition and goals, assessment, psychological intervention, pain and swelling management, range of motion recovery, restoring muscle function, brace use and gait training, and follow-up.

This study summarized the best evidence for early-stage rehabilitation in ACLR patients, providing preliminary guidance for practice. Implementation requires individualization based on graft type, concomitant procedures, baseline activity level, and postoperative complications; moreover, its clinical efficacy and safety warrant further validation.