ACL reconstruction is a common procedure following an ACL rupture. However, the path to recovery can be long and challenging, with a high risk of re-injury if rehabilitation is not approached correctly. A carefully structured early-stage rehabilitation program plays a crucial role in optimizing recovery and ensuring better long-term outcomes for patients. After ACL reconstruction surgery, the focus in the early stages of rehabilitation is on managing the effects of surgery and preparing the knee for the next phases of recovery.
Achieving full extension (straightening) and sufficient flexion (bending) of the knee are important goals in the early stages of ACL recovery. Without proper knee extension, normal walking mechanics cannot be restored, and long-term knee function may be affected. Early motion exercises should begin as soon as possible after surgery to prevent complications such as joint stiffness or scar tissue formation. For most patients, knee extension should be fully restored by around three weeks post-surgery, while flexion of 110-120 degrees is typically targeted by the end of the early-stage rehabilitation
Rebuilding muscle strength, particularly in the quadriceps and hamstrings, is critical to restoring knee stability and function.
However, early-stage strengthening must be carefully managed to avoid overloading the knee and damaging the new ACL graft. Failure to re-establish knee extensor strength can lead to persistent knee pain, an altered gait pattern and a risk towards osteoarthritis development. It takes time for the new graft to be incorporated with the surrounding bone. Being too aggressive with loading in the initial stages can be deleterious towards rehab, so its important to be considerate with exercise choice and workload.
Good movement quality is essential to prevent further injuries and ensure a smooth return to daily activities. Early in the recovery process, patients may experience difficulty in controlling their movements due to muscle weakness and loss of neuromuscular coordination. Relearning how to walk properly and perform basic functional tasks like squats is important to avoid compensatory movement patterns that can lead to re-injury. By following a structured rehabilitation plan and working closely with healthcare professionals, patients can optimize their recovery, reduce the risk of re-injury, and gradually return to their normal activities.
