The modifying factors that help improve anterior cruciate ligament reconstruction rehabilitation: A narrative review

Abstract

Background: : The goal of a rehabilitation programme after anterior cruciate ligament (ACL) reconstruction is to manage a patient's goals and expectations (i.e., returning to physical activities and sports) while minimizing the risk of new injury, particularly a new ACL injury. Although general rehabilitation programmes have been proposed, some factors can lead to adapting each programme to each patient. Objective: : To describe how different variables, including surgical techniques, sports participation, psychosocial and contextual factors can modify the rehabilitation programme. Methods: : We performed a narrative review with input from experts in the field (level of evidence 5). Conclusions: : Modifying factors of the ACL rehabilitation programme are related to the initial lesion or surgery, to sports, or to psychological or social aspects. Regarding the type of graft, the rehabilitation is mainly different in the early postoperative phase; the other phases are not graft-based but rather goal-based rehabilitation. Depending on the meniscal or cartilage repair, the rehabilitation protocol will initially take priority over the anterior cruciate ligament reconstruction protocol. The ACL reconstruction rehabilitation programme should meet the requirements of the anticipated sports, to optimize the athlete's ability to return to the expected level and minimize the risk of reinjury. Psycho-social and contextual factors must also be considered in rehabilitation care to individualize and optimize each patient's programme. (C) 2021 Elsevier Masson SAS. All rights reserved.