Research Article
Volume 12 Issue 9 - 2021
The Evolution of Anterior Cruciate Ligament Reconstruction Rehabilitation Over the Past 20 Years
Ananthi Subramaniam1, Siti Nur Hidayatul Arifah Ibrahim1, Bee Khee Ng1, Rachel Ee Lyn Tan1, Wee Kian Yeo2, Harald Burchardt1 and Joerg Teichmann1*
1Sport Therapy, Rehamed Therapy SDN BHD, Malaysia
2National Sports Institute of Malaysia, Malaysia
*Corresponding Author: Joerg Teichmann, Sport Therapy, Rehamed Therapy SDN BHD, Malaysia.
Received: July 23, 2021; Published: August 28, 2021


Background: The Anterior Cruciate Ligament (ACL) rupture is a common knee injury across various sports, consequently making its reconstruction (ACLr) a common surgical procedure in sports medicine. ACL reconstruction rehabilitation has evolved over the past 20 years.

Aim: To determine the difference in the rehabilitation phases, uses of open and closed kinetic chain exercise, and the testing done before return to play between the 1990s and 2017 onwards.

Methods: The study is done in two stages, (1) articles were retrieved by online database search with keywords for the time period between January 1992 to December 2017. (2) The retrieved articles’ titles, abstracts and content were reviewed to assess the eligibility for the inclusion in this review.

Results: This review has found that over the years the graft choice has evolved from patellar tendon to hamstring tendon autograft. This is to reduce post-surgery complication and reduced ACL re-injury. However, both patellar tendon and hamstring tendon is widely used until today as that both grafts have their own benefits and drawbacks. While, for the rehabilitation phases post ACLr has been revised and improved with more enhanced method of testing before return to sport. The rehabilitation period has been extended to 9 months in the 2000s by adding one more additional phase which is prevention phase, while in 1990s an accelerated rehabilitation program would return the athlete to play in 4 months’ time on average and the return to sport phase started sooner at 4th month. The open and closed kinetic chain exercises can begin as the athlete able tolerate the load, however the angle of the knee has to take into consideration while prescribing the exercises. Variation of the testing battery depending on the sports participated and type of level prior to return to sports are a key indicator of athlete’s readiness post ACLr.

Conclusion: This study concludes that ACLr has evolved significantly in past 20 years together with the graft choice and fixation method. Enhanced graft fixation together with longer rehabilitation process and in-depth testing have resulted in the re-injury of the ACL reconstruction reducing over the years.

Keywords: Anterior Cruciate Ligament (ACL); Anterior Cruciate Ligament Reconstruction (ACLr); Knee Joint


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Citation: Joerg Teichmann., et al. “The Evolution of Anterior Cruciate Ligament Reconstruction Rehabilitation Over the Past 20 Years”. EC Orthopaedics 12.9 (2021): 14-26.

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