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A Systematic Review of ACL Reconstruction Rehabilitation

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Last updated: 24 Dec 2024

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Abstract

Background: Anterior Cruciate Ligament (ACL) reconstruction is a well-known surgical knee procedure performed by orthopaedic surgeons. There is a general consensus for the effectiveness of a postoperative ACL reconstruction rehabilitation program, however there is little consensus regarding the optimal components of a program Objective of the Study: to assess the merits and demerits of current ACL reconstruction rehabilitation programs and interventions based on the evidence supported by previously conducted systematic reviews.   Methods: a Systematic search in the scientific database (Medline, Scopus, EMBASE , and Google Scholer) between 1970 and 2017 was conducted for all relevant Systematic reviews discussing the primary endpoint ( ACL reconstruction rehabilitation ) studies were analyzed and included based on the preset inclusion and exclusion criteria. Study screening and quality was assessed against PRISMA guidelines and a best evidence synthesis was performed. Results: the search results yielded five studies which evaluated eight rehabilitation components (bracing, Continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), open kinetic chain (OKC) versus closed kinetic chain (CKC) exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation). A strong evidence suggested no added benefit of short term bracing (0-6 weeks post-surgery) compared to standard treatment. Whilst a moderate evidence reinforced no added advantage of continuous passive motion to standard treatment for boosting motion range. Furthermore, a moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions including: the use of NMES and exercise, accelerated and non-accelerated rehabilitation, early and delayed rehabilitation, and eccentric resistance programs after ACL reconstruction. Conclusion: short term post-operative bracing and continuous passive motion (CPM) introduce no benefit over standard treatment and thus not recommended. A moderate evidence suggested equal efficiency for 1) CKC and OKC are equally effective for knee laxity, pain and function, at least in the short term (6-14 weeks) after ACL reconstruction and 2) home based and clinic based rehabilitation. Nevertheless, the degree of physiotherapy input remains unclear.  

DOI

10.12816/0038184

Keywords

ACL rehabilitation, pre-operative rehabilitation, post-operative rehabilitation

Authors

First Name

Obada Bashir

Last Name

Awad

MiddleName

-

Affiliation

Almaarefa University

Email

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Orcid

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First Name

Sami Amer M

Last Name

Alqarni

MiddleName

-

Affiliation

King Khalid University

Email

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City

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Orcid

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First Name

Hani Mousa

Last Name

Alkhalaf

MiddleName

-

Affiliation

Intern King Faisal University

Email

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City

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Orcid

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First Name

Faris Ali

Last Name

Alnemer

MiddleName

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Affiliation

King Abdulaziz University

Email

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City

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Orcid

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First Name

Khalid Ayed Abdullah

Last Name

Alahmari

MiddleName

-

Affiliation

King Khalid University

Email

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City

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Orcid

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First Name

Saeed Mubarak Saeed

Last Name

Alshahrani

MiddleName

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Affiliation

King Khalid University

Email

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City

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Orcid

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First Name

Sami Aoudah Tami

Last Name

Alahmari

MiddleName

-

Affiliation

King Khalid University

Email

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City

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Orcid

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First Name

Mohammad Abdul Majeed Abdul

Last Name

Ahad

MiddleName

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Affiliation

Almaarefa University

Email

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Orcid

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First Name

Haitham Sulaiman A

Last Name

Habtar

MiddleName

-

Affiliation

King Khalid University

Email

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City

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Orcid

-

First Name

Mohammed Ali S

Last Name

Almousa

MiddleName

-

Affiliation

King Abdulaziz University

Email

-

City

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Orcid

-

First Name

Abrar Abdulrahman M

Last Name

Alarabi

MiddleName

-

Affiliation

Almaarefa University

Email

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City

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Orcid

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First Name

Salem Baty D

Last Name

Alshahrani

MiddleName

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Affiliation

King Khalid University

Email

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Orcid

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First Name

Fawaz Nawaf

Last Name

Alshaalan

MiddleName

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Affiliation

Prince Sattam Bin Abdulaziz University

Email

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City

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Orcid

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First Name

Mohammed Thamer Shaker

Last Name

Alghalibi

MiddleName

-

Affiliation

Taif University

Email

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City

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Orcid

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First Name

Mohammad Abdullah M

Last Name

Alshahrani

MiddleName

-

Affiliation

King Khalid University

Email

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City

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Orcid

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First Name

Abdullghany Mohammed

Last Name

Dowaikh

MiddleName

-

Affiliation

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Orcid

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Volume

68

Article Issue

1

Related Issue

2461

Issue Date

2017-07-01

Receive Date

2018-09-09

Publish Date

2017-07-01

Page Start

845

Page End

864

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_13019.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=13019

Order

7

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

A Systematic Review of ACL Reconstruction Rehabilitation

Details

Type

Article

Created At

22 Jan 2023