Document Detail


Rehabilitation after anterior cruciate ligament reconstruction: a systematic review.
MedLine Citation:
PMID:  23032584     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Rigorous rehabilitation after anterior cruciate ligament (ACL) reconstruction is necessary for a successful surgical outcome. A large number of clinical trials continue to assess aspects of this rehabilitation process. Prior systematic reviews evaluated fifty-four Level-I and II clinical trials published through 2005.
METHODS: Eighty-five articles from 2006 to 2010 were identified utilizing multiple search engines. Twenty-nine Level-I or II studies met inclusion criteria and were evaluated with use of the CONSORT (Consolidated Standards of Reporting Trials) criteria. Topics included in this review are postoperative bracing, accelerated strengthening, home-based rehabilitation, proprioception and neuromuscular training, and six miscellaneous topics investigated in single trials.
RESULTS: Bracing following ACL reconstruction remains neither necessary nor beneficial and adds to the cost of the procedure. Early return to sports needs further research. Home-based rehabilitation can be successful. Although neuromuscular interventions are not likely to be harmful to patients, they are also not likely to yield large improvements in outcomes or help patients return to sports faster. Thus, they should not be performed to the exclusion of strengthening and range-of-motion exercises. Vibration training may lead to faster and more complete proprioceptive recovery but further evidence is needed.
CONCLUSIONS: Several new modalities for rehabilitation after ACL reconstruction may be helpful but should not be performed to the exclusion of range-of-motion, strengthening, and functional exercises. Accelerated rehabilitation does not appear to be harmful but further investigation of rehabilitation timing is warranted.
LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Authors:
L M Kruse; B Gray; R W Wright
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  94     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-03     Completed Date:  2012-12-17     Revised Date:  2013-12-11    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1737-48     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Anterior Cruciate Ligament / injuries*,  surgery
Anterior Cruciate Ligament Reconstruction / methods,  rehabilitation*
Braces / utilization
Exercise Therapy / methods*
Female
Follow-Up Studies
Humans
Knee Injuries / radiography,  rehabilitation*,  surgery
Male
Pain Measurement
Postoperative Care / methods
Randomized Controlled Trials as Topic
Range of Motion, Articular / physiology*
Recovery of Function
Risk Assessment
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Clin J Sport Med. 2013 Nov;23(6):501-2   [PMID:  24169301 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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