Physiotherapy Dubai | 1 February 2025
Restoring range of motion (ROM) strength, neuromuscular control, and gait training are the goals of the ACL Rehabilitation Protocol. It also aims to lessen oedema and inflammation. Complete strength and power restoration, sport-specific training, and reconditioning are all part of the later stage of recovery. After every workout or session, the patient needs to be taught how to control their pain. If discomfort, swelling, or inflammation develops, ice may need to be used. Weight bearing status is primarily dictated by concurrent injuries (e.g. meniscal repair) immediately following surgery. Until sufficient quadriceps muscle strength is regained, isolated ACL repairs are usually managed with weight bearing as tolerated and crutches and/or braces. During the first two weeks, we should be able to stop using crutches and start bearing our own weight. Although the outcomes of ACL restoration are favourable, there are several difficulties and possible problems with the methods used today. These include lack of proprioception, anterior knee discomfort, and weakened hamstrings. Furthermore, there is strong evidence that ACL restoration does not shield against osteoarthritis in the future.
Every patient should have their own RTR decision-making process.There isn’t a single timeline to RTR. If there is sufficient loading—pain <2 on the visual analogue scale (VAS), 95% knee flexion range of motion, complete knee extension range of motion, and no effusion—most patients may be ready to RTR between weeks 8 and 16. For individualised therapeutic decision-making on RTR, the doctor may decide to use a variety of tests, including as strength testing, quantitative performance-based assessments like hop tests, and qualitative performance-based assessments that emphasise dynamic knee control.
A variety of bracing techniques, such as functional bracing, rehabilitative bracing, and knee immobilisation, were assessed. Overall, the absence of braces or the length of brace wear showed a benefit over other brace types, brace durations, or no bracing at all. Bracing is not required and offers no advantages.There have been no negative consequences from Accelerated Rehabilitation, therefore patients can probably start weight-bearing right after surgery, move their knee from 0 to 90 degrees of flexion, and do closed-chain strengthening exercises without risk.
Three weeks following surgery, eccentric quadriceps and isokinetic hamstring strengthening were safely added; additional research is required to determine whether they are safe earlier.Rehabilitation at home can be successful. Although neuromuscular workouts are unlikely to cause harm to patients, their impact was minimal, which means that they are unlikely to result in significant improvements in outcomes or hasten a patient’s return to sports. Strengthening and range-of-motion exercises should not be neglected in favour of neuromuscular workouts.
Supplementing with vitamin C or vitamin E doesn’t seem to help.Although the expense of postoperative hyaluronic acid injections must be considered, they may improve certain quantifiable metrics.Cycling on one leg might help preserve heart fitness. It is still not advised to use continuous passive motion (CPM). In order to safely enable a speedy restoration of mobility, strength, and eventually sport participation, the studies discussed in this paper concentrated on enhancing rehabilitation after ACL reconstruction. Few studies, nonetheless, truly assessed the participants’ capacity to resume sports and when they did so after the interventions. The availability of such data should be taken into account in future research since it has the potential to support study conclusions. To continue to enhance patient care and function after ACL repair, more research on the time of rehabilitation and additional rehabilitation exercises is required, even with the abundance of randomised studies.
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