Rehabilitation protocols after bone-patellar tendon-bone anterior cruciate ligament reconstruction have become significantly more aggressive over the past decade. Key concepts of an accelerated rehabilitation protocol include immediate full weight bearing, unrestricted range of motion, early closed kinetic exercises, and return to play by 4 months. Additional components of a successful rehabilitation program include appropriate timing of surgery, adequate postoperative analgesia, use of cryotherapy, and diligent surveillance for the development of postoperative motion complications. In addition to thorough patient evaluation and meticulous surgical technique, a comprehensive rehabilitation protocol for the reconstructed knee is an essential part of the overall treatment algorithm of the anterior cruciate ligament injured extremity. This article reviews a variety of different factors involved in successful rehabilitation after anterior cruciate reconstruction using patellar bone-tendon-bone autograft and presents a comprehensive rehabilitation protocol.
I always try to stay on top of recent research, both for my own clinical skills but also for my physical therapy blog. I will use this blog to post some of the latest and greatest with some clinical implications, but this post is almost the reverse! I was reading through the current issue of the journal Techniques in Orthopaedics today and found an article that perked my interest, entitled Rehabilitation After Patellar Tendon Autograft Anterior Cruciate Ligament Reconstruction. As I started to read the article, I glanced at the authors and noticed it was written by two orthopedic surgeons, no physical therapist or other rehabilitation specialist was listed. The abstract wasn’t bad:
I have to admit, though, I stopped reading it. I am not sure how I feel about an article about rehabilitation that is written by orthopedic surgeons with no collaboration from a physical therapist. I realize that the journal is an orthopedic surgery technique journal, but I was reading it so there must be more people like me that are not surgeons that at least glance at the table of contents. If you use my website that automatically collects all the new table of contents of orthopedic journals than you may have read it too!
Don’t get my wrong, I know the authors are excellent surgeons and respect their work. They are , credible but I wonder if we are doing the rehabilitation justice if the authors do not actually conduct the rehabilitation. How do they know the day-to-day intricacies of the rehabilitation progression?
Does anyone else agree?