A Comparative Analysis Of Anterior Cruciate Ligament Reconstruction Rehabilitation Protocols In Southwest Michigan
BACKGROUND: A thorough rehabilitation program is critical to achieving a satisfactory outcome following anterior cruciate ligament reconstruction (ACLR). However, there remain gaps in knowledge and there is yet to be a single consensus rehabilitation protocol. The purpose of our study is to identify areas of ACLR rehabilitation in which patient outcomes could be improved through further research.
HYPOTHESIS: There are differences in the ACLR rehabilitation programs used by surgeons and these differences are not supported by evidence in literature.
METHODS: ACLR rehabilitation protocols were acquired and compared from six different Orthopaedic Surgeons in Southwest Michigan from different physical therapy facilities. Protocol directives were categorized as bracing, range of motion, weight bearing, strengthening, neuromuscular training, and sport functional exercises.
RESULTS: There is a significant variation in rehabilitation protocols with respect to bracing, strengthening, neuromuscular training, and sport functional exercises. The lack of use of post-operative bracing was supported by the literature. Differences in the initiation of various exercises had no studies in the literature to demonstrate medical evidence. Weight bearing status was the only category in which there was a universal consensus within all protocols.
CONCLUSION: There are many differences between surgeons' protocols for ACLR rehabilitation following surgery. Many of the differences cannot be supported by medical evidence seen in the literature. This may suggest that current practice guidelines for rehabilitation protocols for ACLR are products from the surgeons' postgraduate training. Efforts should be made to improve existing rehabilitation protocols with appropriate medical evidence, which would help improve patient outcomes.