Postoperative Rehabilitation of Anterior Cruciate Ligament Reconstruction

Abstract

Anterior cruciate ligament injury is commonly seen in sports related trauma. Complete tear requires surgical reconstruction. During postoperative rehabilitation, because of arthrogenic muscle inhibition (AMI), the quadriceps muscle remains inactive and has reduced contraction. Various strategies were aimed at treating this AMI and/or improve quadriceps strength such as open chain (OKC) and closed chain kinetic (CKC) exercises, blood flow resistance training (BFRT), cryotherapy, and transcutaneous nerve stimulation (TENS). Of all these, CKC was better than OKC in improving the range of movements, weight bearing exercises provided quicker return to physical activity. Cryotherapy was found to be an effective way to counter AMI and improve knee function and reduce the pain. The BFRT and TENS were found to be ineffective. Single legged hop test at six months postoperatively was found to be reliable predictor of the quadriceps function at one year. Electromechanical dynamometry is the gold standard machine to assess the knee extension and provide exercise, handheld dynamometry is easy to use. Leg press, leg extension machine are other machines used to provide exercises.