A Survey of Rehabilitation Regimens Following Isolated ACL Reconstruction

Anterior Cruciate Ligament (ACL) reconstruction is a well-established and widely practiced surgical procedure. Wide variation in surgical techniques and postoperative rehabilitation may predispose to early graft failure or sub-optimal functional outcomes. Surgical technique has been investigated extensively.
There is little data as to the effect of rehabilitation regimens. This article assesses the current rehabilitation practices after ACL reconstruction within London, UK. Materials and Method: A survey of all NHS (National Health Service) physiotherapy departments that provide rehabilitation for patients undergoing isolated ACL reconstruction in the Greater London area
Results: 38 physiotherapy departments participated in our study. Of these, only 31 (81.6%) had written rehabilitation guidelines. A majority of departments, 31 (81.6%), adopted immediate post-operative full weight bearing. Day surgery ACL reconstruction was performed routinely at 27 (71.0%) units. Braces were used in only 12 (31.6%) departments. Rehabilitation milestones (e.g. return to sports) varied significantly across the study group. Discussion: This survey demonstrates a significant variation in rehabilitation regimens following ACL reconstruction. Current trends are towards day case surgery, immediate weight bearing, and reduced use of bracing. National ligament registries allow for multivariate analysis to identify variables associated with graft failure and sub optimal outcomes. Presently no registries collect data on rehabilitation regimens.