Abstract
The goal of the rehabilitation after an anterior cruciate ligament reconstruction is to assure that the athlete can return to sports and avoid reinjury in the short term and that there is minimal risk for other injuries in the long term. The recommendation in the current literature is to implement a well-planned, individualized, and criteria-based rehabilitation program as soon as possible, preferably on the same day as surgery. The rehabilitation has to be based on knowledge about the healing process after reconstruction, about the effect of rehabilitation techniques and exercise on tissue, and about the short- and long-term consequences of the injury. It has also to be individualized to meet each athlete’s personal physiological and psychological needs regarding the extent of the injury and sports-related demands on the knee. The structured rehabilitation model that is presented in this chapter consists of four rehab phases, which take the patient and the phases of the tissue healing process into consideration.
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References
Adams D, Logerstedt DS et al (2012) Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression. J Orthop Sports Phys Ther 42(7):601–614
Andersson D, Samuelsson K et al (2009) Treatment of anterior cruciate ligament injuries with special reference to surgical technique and rehabilitation: an assessment of randomized controlled trials. Arthroscopy 25(6):653–685
Ardern CL, Webster KE et al (2011) Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 45(7):596–606
Ardern CL, Taylor NF et al (2012) A systematic review of the psychological factors associated with returning to sport following injury. Br J Sports Med 47(17):1120–1126
Ardern CL, Taylor NF et al (2013) Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. Am J Sports Med 41(7):1549–1558
Bandura A (1986) The explanatory and predictive scope of self-efficacy theory. J Clin Soc Psychol 4:359–373
Bandura A (1995) Comments on the crusade against the causal efficacy of human thought. J Behav Ther Exp Psychiatry 26(3):179–190
Beynnon BD, Uh BS et al (2005) Rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind comparison of programs administered over 2 different time intervals. Am J Sports Med 33(3):347–359
Coppola SM, Collins SM (2009) Is physical therapy more beneficial than unsupervised home exercise in treatment of post surgical knee disorders? A systematic review. Knee 16(3):171–175
Eitzen I, Holm I et al (2009) Preoperative quadriceps strength is a significant predictor of knee function two years after anterior cruciate ligament reconstruction. Br J Sports Med 43(5):371–376
Escamilla RF, Macleod TD et al (2012a) Anterior cruciate ligament strain and tensile forces for weight-bearing and non-weight-bearing exercises: a guide to exercise selection. J Orthop Sports Phys Ther 42(3):208–220
Escamilla RF, Macleod TD et al (2012b) Cruciate ligament loading during common knee rehabilitation exercises. Proc Inst Mech Eng H 226(9):670–680
Glass R, Waddell J et al (2010) The effects of open versus closed kinetic chain exercises on patients with ACL deficient or reconstructed knees: a systematic review. N Am J Sports Phys Ther 5(2):74–84
Heijne A, Werner S (2007) Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study. Knee Surg Sports Traumatol Arthrosc 15(4):402–414
Heijne A, Ang BO et al (2009) Predictive factors for 12-month outcome after anterior cruciate ligament reconstruction. Scand J Med Sci Sports 19(6):842–849
Kruse LM, Gray B et al (2012) Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am 94(19):1737–1748
Kvist J (2004) Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation. Sports Med 34(4):269–280
Kvist J (2006) Tibial translation in exercises used early in rehabilitation after anterior cruciate ligament reconstruction exercises to achieve weight-bearing. Knee 13(6):460–463
Kvist J, Good L et al (2007) Changes in knee motion pattern after anterior cruciate ligament injury – case report. Clin Biomech (Bristol, Avon) 22(5):551–556
Lobb R, Tumilty S et al (2012) A review of systematic reviews on anterior cruciate ligament reconstruction rehabilitation. Phys Ther Sport 13(4):270–278
Locke EA, Frederick E et al (1984) Effect of self-efficacy, goals and task strategies on task performance. J Appl Psychol 69:241–251
Maddison R, Prapavessis H et al (2006) Modeling and rehabilitation following anterior cruciate ligament reconstruction. Ann Behav Med 31(1):89–98
Mikkelsen C, Werner S et al (2000) Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc 8(6):337–342
Myer GD, Paterno MV et al (2006) Rehabilitation after anterior cruciate ligament reconstruction: criteria-based progression through the return-to-sport phase. J Orthop Sports Phys Ther 36(6):385–402
Raynor MC, Pietrobon R et al (2005) Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg 18(2):123–129
Risberg MA, Lewek M et al (2004) A systematic review of evidence for anterior cruciate ligament rehabilitation: how much and what type? Phys Ther Sport 5:125–145
Risberg MA, Holm I et al (2007) Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: a randomized clinical trial. Phys Ther 87(6):737–750
Shaw T, Chipchase LS et al (2004) A users guide to outcome measurement following ACL reconstruction. Phys Ther Sport 5:57–67
Sturgill LP, Snyder-Mackler L et al (2009) Interrater reliability of a clinical scale to assess knee joint effusion. J Orthop Sports Phys Ther 39(12):845–849
Tagesson S, Oberg B et al (2008) A comprehensive rehabilitation program with quadriceps strengthening in closed versus open kinetic chain exercise in patients with anterior cruciate ligament deficiency: a randomized clinical trial evaluating dynamic tibial translation and muscle function. Am J Sports Med 36(2):298–307
Tagesson S, Oberg B et al (2009) Tibial translation and muscle activation during rehabilitation exercises 5 weeks after anterior cruciate ligament reconstruction. Scand J Med Sci Sports 20(1):154–64
Thomee R (1997) A comprehensive treatment approach for patellofemoral pain syndrome in young women. Phys Ther 77(12):1690–1703
Thomee P, Wahrborg P et al (2008) Self-efficacy of knee function as a pre-operative predictor of outcome 1 year after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 16(2):118–127
Thomee R, Kaplan Y et al (2011a) Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19(11):1798–1805
Thomee R, Swärd L et al (2011b) Sports injuries and their rehabilitation. SISU, Stockholm
van Grinsven S, van Cingel RE et al (2010) Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18(8):1128–1144
Walden M, Hagglund M et al (2011) Anterior cruciate ligament injury in elite football: a prospective three-cohort study. Knee Surg Sports Traumatol Arthrosc 19(1):11–19
Walden M, Atroshi I et al (2012) Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. BMJ 344:e3042
Webster KE, Feller JA et al (2008) Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery. Phys Ther Sport 9(1):9–15
Wright RW, Preston E et al (2008a) A systematic review of anterior cruciate ligament reconstruction rehabilitation: part I: continuous passive motion, early weight bearing, postoperative bracing, and home-based rehabilitation. J Knee Surg 21(3):217–224
Wright RW, Preston E et al (2008b) A systematic review of anterior cruciate ligament reconstruction rehabilitation: part II: open versus closed kinetic chain exercises, neuromuscular electrical stimulation, accelerated rehabilitation, and miscellaneous topics. J Knee Surg 21(3):225–234
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Thomeé, R., Kvist, J. (2014). Structured Rehabilitation Model with Clinical Outcomes After ACL Reconstruction. In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_104-1
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DOI: https://doi.org/10.1007/978-3-642-36801-1_104-1
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