Rehabilitation following intraarticular anterior cruciate ligament (ACL) reconstruction has undergone a dramatic evolution during the last decade. This paper describes our accelerated rehabilitation program, which is divided into four phases. The preoperative phase begins immediately after injury and emphasizes control of swelling and restoration of full range of motion (ROM) and strength before surgery. Phase II, which includes the first 2 weeks after surgery, emphasizes helping the patient obtain full terminal knee extension and weight bearing. The final two phases focus on improving lower extremity strength and full return to daily and athletic activities. This accelerated program has resulted in an earlier return of ROM and strength as well as a decrease in postoperative procedures, without compromising ligamentous stability.
The authors are with Methodist Sports Medicine Center, 1815 North Capital Ave., Suite 500, Indianapolis, IN 46202.