Accelerated Rehabilitation after Anterior Cruciate Ligament Reconstruction1

To overcome many of the complications after ACL reconstruction (prolonged knee stiffness, limitation of complex extension, delay in strength recovery, anterior knee pain), yet still maintain knee stability, we developed a rehabilitation protocol that emphasizes full knee extension on the first postoperative day and immediate weightbearing according to the patient's tolerance. Of 800 patients who underwent intraarticubr ACL patellar tendon-bone graft reconstruction, performed by the same surgeon, the last 450 patients have followed the accelerated rehabilitation schedule as outlined in the protocol. A longer than 2 year followup is recorded for 73 of the patients in the accelerated rehabilitation group. On the 1st postoperative day, we encouraged these patients to walk with full weightbearing and full knee extension. By the 2nd postoperative week, the patients with a 100° range of motion participated in a guided exercise and strengthening program. By the 4th week, patients were permitted unlimited activiti...