We based the protocol on a series of Systematic Reviews we performed to establish the evidence for best practice ACL rehabilitation. Previously we discussed the first 2 reviews. Here we will review the findings in our 3rd review which was an update of the original 2. It can be found HERE. In this study we discussed an additional study evaluating the use of Continuous Passive Motion machines which once again showed no advantage. Several additional studies had been published evaluating bracing and none demonstrated any advantage in the postoperative rehabilitation period. Additional studies evaluated early ROM and quad strengthening without any increase in laxity. Eccentric strengthening was safe and showed improved strength gains compared to concentric strengthening when initiated at 3 weeks and continuing for 12 weeks. Accelerated rehab shortening to 5 months the recovery did not result in worse outcomes or safety issues. Additional electrical stimulation studies showed safety, but no significant efficacy in ACL rehabilitation.
Most additional studies performed since our last review reiterated our additional findings. I will be presenting specific findings for revision ACL reconstruction rehabilitation at the July 2016 American Orthopaedic Society for Sports Medicine and we will blog those results when available next week.