Guidelines for rehabilitation after anterior cruciate ligament reconstruction of the knee

  ACL injuries, tears and ruptures are sports injuries that occur frequently in basketball, soccer and other rival sports. When the ACL is severely torn or ruptured, it can seriously affect a person’s athletic ability and even normal walking, at which point surgical reconstruction of the ACL becomes very necessary and must be done to restore normal athletic function.  The degree of functional recovery after an ACL injury takes depends on two main aspects: the perfection of the surgeon’s surgery and the level of rehabilitation training of the rehabilitation therapist. Once the surgery is completed, the degree of functional recovery is then determined entirely by the level of rehabilitation.  Post-operative time 1~day 2: Cold compresses with pressure every 2 hours for 15 minutes to reduce post-operative swelling and pain.  Postoperative day 2 ~ week 2: Rehabilitation training mainly includes ankle pump, sliding board, quadriceps isometric contraction, ball clenching, straight leg raising, calf raising action is strictly prohibited to prevent affecting the stability of reconstructed ligaments, and cold compresses must be applied after the completion of rehabilitation training to eliminate swelling and pain brought about by the training. The rehabilitation goal of this phase is 60~75 degrees of mobility, eliminating postoperative reactions and reducing the degree of muscle atrophy.  Postoperative week 2~4: The rehabilitation training mainly includes ankle pump, skateboard, quadriceps isometric contraction, straight leg raise, ball clenching, N cord muscle training, calf lifting is strictly prohibited to prevent the stability of reconstructed ligaments, and cold compresses must be applied after the completion of rehabilitation training to eliminate the swelling and pain caused by training. The rehabilitation goal of this stage is 90~100 degrees of mobility, appropriate increase of overall muscle strength of the lower limb, and 25~50% weight bearing of the affected limb.  Postoperative week 4~6: The rehabilitation training mainly includes ankle pump, skateboard, quadriceps isometric contraction, straight leg raise, ball clenching, N cord muscle training, calf lift, increase the stress of reconstructed ligaments, increase the power car movement and appropriate gait training, and make sure to apply cold compresses after the rehabilitation training to eliminate the swelling and pain brought by the training. The rehabilitation goals for this phase are 100~120 degrees of mobility, appropriate increase in overall muscle strength of the lower extremity, and weight bearing of 50~100% of body weight on the affected extremity.  Postoperative week 6~8: The rehabilitation training mainly includes skateboard, straight leg raise, ball clutching, N cord muscle training, calf lift, power bike, gait training, balance and proprioceptive training, and cold compresses must be applied after the rehabilitation training is completed to eliminate swelling and pain caused by the training. The rehabilitation goal for this phase is to have a mobility of 120 degrees or more, increase the overall muscle strength and stability of the lower extremity, and allow 100% weight bearing of the affected extremity.  More than 2 months post-operative: The rehabilitation is more flexible and still focuses on increasing muscle strength and stability, balance and proprioceptive training are indispensable, and running training and more specific motor skills are added. The goal of rehabilitation is to achieve normal running and specific sports ability.  The above is the general rehabilitation process and rehabilitation goals after ACL reconstruction. While implementing the overall plan, the training progress should be increased or slowed down appropriately according to each patient’s own situation. The patient must follow the rehabilitation plan to the letter.