Rehabilitation after autogenous bone-patellar tendon-bone ACL reconstruction.

In the past decade, changes in the rehabilitation of patients with ACL injuries have made a dramatic impact on the management of the surgically treated ACL-deficient knee. Our rehabilitation program following the ACL reconstruction has been developed over the past 12 years. With close follow-up of our patients, we have modified the rehabilitation program in an attempt to eliminate postoperative complications, ensure long-term knee stability, and allow a safe and rapid return to athletic activities. Our present rehabilitation protocol is divided into four phases. The initial phase encompasses the preoperative period. The second phase involves the first 2 weeks after ACL reconstruction. The third phase extends from 2 to 5 weeks postoperation, and the final phase (> than 5 weeks postoperation) involves a safe return to athletic activities. An aggressive preoperative phase and close attention to full hyperextension, control of swelling, and good leg control during the first postoperative phase are the cornerstones of the rehabilitation program. We continue to evaluate our results closely and to advance our rehabilitation program guided by our patients and continuous follow-up evaluations. We propose that the avoidance of immediate surgery and appropriate preoperative patient preparation, along with postoperative rehabilitation program that emphasizes extension and closed chain function exercises, will optimize the final result.