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Rehabilitation for Anterior Cruciate Ligament Injury Follow-up

  • Author: Tarek O Souryal, MD; Chief Editor: Consuelo T Lorenzo, MD  more...
 
Updated: Mar 01, 2016
 

Deterrence

See Causes .

In a paper published by Hewett and coauthors, a jump training program was recommended strongly.[24] Another paper, by Wojtys and colleagues, showed that plyometrics and exercises requiring agility, such as running through cones, figure eights, and single leg jumps, are proven methods to improve muscle reaction time significantly.[25]

Ultimately, physical conditioning and balanced knee strengthening (hamstrings as well as quadriceps) are the keys to reducing the risk of an ACL tear.

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Complications

Complications from ACL surgery generally arise during surgery (see Allograft Reconstruction, ACL-Deficient Knee). Complications include the following:

  • Extravasation of irrigation fluid during arthroscopy
  • Posterior femoral cortex compromise during endoscopic reaming of the femoral tunnel
  • Paresthesias along the lateral aspect of the knee
  • Improper handling of the graft (eg, dropping it on the floor)
  • Bruising and/or hematoma formation
  • Blood loss
  • Improper alignment of the tunnels, causing graft impingement
  • Improper graft placement, making the graft too short and thus not allowing the knee to reach full terminal extension

The main complication of ACL surgery during the postoperative period is rupture of the graft. Careful and conservative physical therapy (PT) during the first 8-12 weeks is important (see Physical Therapy).

Another complication that can develop after surgery is failure to achieve full knee extension (see Physical Therapy).

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Prognosis

Most patients achieve good health and mobility after treatment for ACL injury. More than 75% of all patients who undergo ACL repair return to their previous level of functioning. They perform ADL without difficulty and return to participation in their previous sporting or recreational activities.

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Patient Education

See the list below:

  • See Physical Therapy.
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Contributor Information and Disclosures
Author

Tarek O Souryal, MD Head Team Physician, Dallas Mavericks; Director, Texas Sports Medicine and Orthopaedic Group; Staff, Department of Orthopaedic Surgery, Presbyterian Hospital of Dallas; Clinical Professor, Departments of Orthopedic Surgery and Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center

Tarek O Souryal, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Received honoraria from Allergan for speaking and teaching.

Chief Editor

Consuelo T Lorenzo, MD Medical Director, Senior Products, Central North Region, Humana, Inc

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Additional Contributors

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, Texas Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Kenneth Adams, MD Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical School

Kenneth Adams, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

References
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