What rehabilitation protocols are recommended for patients recovering from ACL reconstruction?

Rehabilitation protocols for patients recovering from anterior cruciate ligament (ACL) reconstruction should start as early as possible after surgery, ideally the day after, to maintain and restore range of movement and muscle strength. This includes a structured exercise programme focusing on range of movement exercises, muscle strengthening, and gait re-education once weight-bearing is permitted. Early mobilisation and controlled motion devices may be used to assist with joint movement if independent exercise is not possible. Splinting and orthotics should be considered to maintain joint range of movement and prevent complications. Psychological support should be offered throughout the rehabilitation process to address emotional and psychological needs. Rehabilitation should be multidisciplinary, involving physiotherapists and other specialists to tailor the programme to the individual's recovery goals and functional needs.

Key components include:

• Starting rehabilitation therapy early (ideally the day after surgery) to maintain range of movement and prevent contractures.
• Implementing a programme of passive, active assisted, or active range of movement exercises for the knee joint.
• Progressing to muscle strengthening exercises and gait re-education as soon as weight-bearing is possible.
• Using controlled motion devices if the patient cannot perform exercises independently.
• Regularly reviewing and managing splints or orthoses to maintain joint function and prevent complications.
• Providing psychological support throughout recovery.

This approach aims to optimise functional recovery, reduce complications such as stiffness or muscle atrophy, and support the patient’s return to daily activities and mobility.

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