Abstract

An aggressive rapid rehabilitation program can return athletes quickly and safely to their previous levels of activity following anterior cruciate ligament reconstruction (ACLR). An intra-articular, bone-patellar tendon-bone procedure without extra-articular reconstruction provides a solid fixation and, when isometrically placed, allows an aggressive rehabilitation program. The early results of the program are very encouraging. Athletes have returned to competitive athletics at 4 to 6 months postoperatively, depending upon strength, functional ability, and sport activity. Early motion and weight bearing are the cornerstones of the program. It has been documented in a study by one of the authors that there was no significant difference in anterior-posterior laxity between early motion/early weight bearing patients versus braced or casted/delayed weight bearing patients in a follow-up of 137 ACLR cases. Continuous passive motion (CPM) begins immediately following surgery while the patient remains under the effect of a long-lasting regional anesthetic. The formal rehabilitation program begins at 5 to 7 days postoperatively. Passive extension/flexion, stationary bicycling, muscle stimulation, and a series of heavy rubber tubing exercises are started at this time. Patients progress from partial to full weight bearing within two weeks post-operatively. Emphasis is placed on closed kinetic chain activities (leg press, quarter squat, etc.) and proprioceptive exercises as the rehabilitation progresses. Verf.-Referat (gekuerzt)