This Clinical Practice Guideline document describes the evidence of effectiveness for the components of rehabilitation after anterior cruciate ligament reconstruction (ACLR). This information can be then used to inform ACLR rehabilitation protocols. The Guideline is intended for the use of physiotherapists managing patients after ACL in outpatient clinics, as well as physicians, orthopedic surgeons, athletic trainers, nurse practitioners, and other healthcare professionals that also benefit.
Insurance companies, governmental bodies, and health-policy decision makers may also find it useful as an evolving standard of evidence regarding rehabilitation after ACLR. in addition to researchers who will find this highlights gaps in the literature and grey areas that require further enquiry.
The Guideline targets patients during rehabilitation after ACLR and investigates the effectiveness of the available interventions to the physiotherapist, alone or in combination (e.g., exercise, modalities, objective progression criteria. Exercise interventions should be considered the mainstay of ACLR rehabilitation, however, there is little evidence on the dose-response relationship between volume and/or intensity of exercise and outcomes.
Physical therapy modalities can be helpful as an adjunct in the early phase of rehabilitation when pain, swelling, and limitations in range of motion are present. Adding modalities in the early phase may allow earlier pain-free commencement of exercise rehabilitation. Return to running and return to training/activity are key milestones for rehabilitation after ACL. however, there is no evidence on which progression or discharge criteria should be used