Accelerated rehab after (ACL) anterior cruciate ligament reconstruction offers significant benefit to younger, active adults and athletes, who cannot afford prolonged downtime. Customized to individual patient needs, it helps in rapid recovery, faster recuperation, less discomfort, and quick return to training.
What is accelerated rehab?
Accelerated rehab refers to faster recovery and post-surgical recuperation without compromising the healing process. It accelerates the restoration of the full movement of the knee and its biomechanical strength allowing return to work sooner than traditional rehabilitation ensures. The recovery duration is almost halved.
The key element of accelerated rehab is the reduced recovery time after ACL reconstruction. The rehabilitation regimen in designed in such a way that it provides all benefits of traditional post-surgical rehab, but with significantly reduced downtime.
Patients are able to achieve full functional movement of the knee as soon as possible without any risk of future reinjury or compromise with their physical safety.
What is ACL reconstruction?
The anterior cruciate ligament or ACL prevents extreme, inward twisting of the knee joint and ensures its stability. However, excessive load or stress, too much landing pressure, sudden knee maneuver, forceful contact, excessive knee joint twisting, or sudden change of direction ruptures or damages the ligament. This leads to restricted knee mobility and pain requiring surgical reconstruction of the ligament.
ACL reconstruction involves rebuilding of the damaged ligament. The torn ligament is removed and a new ligament is rebuilt from tissue harvested from patellar or quadriceps tendons.
What is the need for a structured post-ACL reconstruction rehab?
Rehabilitation after ACL reconstruction is key to restore the lost knee joint structural and functional strength and avoid the risk of reinjury. It helps reduce inflammation, increase biomechanical motion in an orderly manner, and restore optimum knee joint agility and strength equal to the uninvolved knee and with focus on patient safety and freedom from injury. This also provides psychological boost to reinforce physiological attributes to lead an injury-free life and have better muscle leg control.
Why should I go for accelerated rehab after ACL reconstruction?
Going for accelerated rehab after ACL reconstruction offers a number of benefits, including
- faster recovery
- reduced post-surgical downtime
- career saving for athletes , as they are able to return to sports
- best suited for young people undergoing ACL reconstruction
- progressive approach to post-ACL surgery rehab
- improved final outcome in lesser time frame recovery
- return to excellent stability and strength and full range of motion and function in quickest possible time
- custom-made rehab protocol ensures low chance of postoperative complications, such as knee joint pain and stiffness
- maximum outcome following ACL reconstruction
How good is accelerated rehab compared to traditional rehab?
Researchers suggest a number of benefits associated with accelerated rehab after ACL reconstruction when compared to traditional rehab. It assures early healing, faster muscle activation, reduced time for rest and recuperation, and faster return to work. The recovery time is almost halved allowing athletes to resume their career without any difference in long-term knee joint stability offered by traditional rehab.
Accelerated rehab ensures early knee muscle control. Studies indicate such early control is vital to regain complete quadriceps muscle strength without any flaw. The multi-modal approach of accelerated rehab ensures early pain relief and decreased dependent on painkillers.
A Spanish study links accelerated rehab after ACL reconstruction to greater muscle force, faster compensation for muscle atrophy, reduced hamstring muscle strains, and better muscle isokinetic performance. This plays a crucial role in subduing swelling, allowing enhanced knee agility and strength, and providing good range of movements.
According to a 2011 study reported in the American Journal of Sports Medicine, accelerated rehab after ACL reconstruction produce same benefits as traditional rehab while reducing the downtime considerably. Functional performance, knee strength, and proprioception achieved by accelerated rehabilitation are no way inferior to non-accelerated rehab.
How is a regimen for accelerated rehab after ACL reconstruction developed?
Accelerated rehabilitation after ACL surgery takes into cognizance three factors – the actual condition of a patient, the surgical process, and the ability to cope with accelerated rehab. Based on these considerations, a customized, scientific, and multi-modal regimen is developed. The approach focuses on early healing, rapid recovery, swift regaining of knee strength, faster return to normalcy, and prevention of reinjury.
What are important components of accelerated rehab after ACL reconstruction?
- Advanced pain management
- Progressive rehabilitation to help patients up and moving sooner than expected
- Comprehensive and customized planning and education
- Early discharge and post-operative care
- Rapid Recovery coaching
- Expert orthopedic guidance
- Regular follow-up
What does accelerated rehab after ACL reconstruction include?
Accelerated rehabilitation after ACL reconstruction is a multi-faceted approach that includes several techniques to ensure rapid and swift recovery.
When should I join accelerated rehab?
Accelerated rehabilitation begins at the pre-surgery stage. Pre-surgical conditioning is provided to ensure that there is no need for extended downtime after the ACL reconstruction and patients experience minimum pain, regain maximum knee stability, get up and moving soon after the surgery, and respond positively to the rapid recuperation techniques.
During the surgical process, procedures that assure fast recuperation and early return to normalcy are preferred over more invasive ones.
How is accelerated rehab after ACL reconstruction performed?
Accelerated rehabilitation starts immediately after ACL reconstruction as soon as the patient wakes up in the recovery room. Long-acting anesthetic and anti-inflammatory medication administered to tissues surrounding the knee to block pain pathways and allow the patient to start rehab right from the recovery room without feeling pain. This also minimizes the dependence on narcotic painkillers and reinforces the ability to join the rehabilitation.
A combination of physiotherapy, medication, nutrition, and other non-medical therapies is used to lessen complications and fatigue while fast tracking recovery, restoration of knee joint strength, and recuperation. The rehab process continues during the hospital stay and even after the patient is discharged under expert supervision. Continued follow up for a few months ensures the patients is on the right track and remains injury free.
Do I need to stay in the hospital during accelerated rehab after ACL reconstruction?
No need to stay in the hospital for the entire duration of the accelerated rehab after ACL reconstruction. You can continue it in consultation with your therapist while recuperating at home. However, you may have visit the therapy center regularly to take a stock of your progress.
Is my therapist licensed?
Yes, all therapists are certified and licensed. Accelerated rehab after ACL reconstruction must be carried on under the guidance of expert and experienced therapists.
Is accelerated rehab painful?
No. Pain management is an integral part of accelerated rehab. It offers freedom from pain and healing after ACL reconstruction at the earliest. As pain and swelling subside rapidly, recovery becomes quick.
Do I need to take any precaution?
Accelerated rehab after ACL reconstruction requires patients to strictly follow the suggestions by therapists. Pushing your knee ligament beyond the level f tolerance may affect the functional strength of the knee joint at the early stage. Usually, muscles shut down after a surgery. Rehabilitation aims at restoring the functional strength of these muscles connecting to the knee. However, excessive stress or forced movements beyond what rehab regimen prescribes may cause chronic knee instability.
Is bracing necessary during accelerated rehab after ACL reconstruction?
The focus on developing protective factors, such as muscular potency, functional movements, and proprioceptive stability, for knee joint reduces the need for bracing.
Does accelerated rehab after ACL reconstruction contribute to knee arthritis?
There is no evidence linking accelerated rehab after ACL reconstruction to knee arthritis. It does not contribute to the degenerative disorder. Proper rehab, rather, has the potential to prevent occurrence of any degenerative disease.
Does the type of graft used influence accelerated rehab?
No, everyone can undergo accelerated rehab irrespective of the type of graft used. The only requirement is that the graft is of right size, at right tension, firmly fixed, and in compliance to isometric requirements.
Does it help to tackle pain?
Yes, accelerated rehab offers best possible way to get rid of pain and swelling after ACL reconstruction.
How long does accelerated rehab take?
Accelerated rehab almost haves the downtime required for recovery. Athletes undergoing accelerated rehab after ACL reconstruction returns to training in 4 to 6 months compared to 9 to 12 months required by traditional rehabilitation.
Shelbourne KD, Gray T. Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation. Am J Sports Med. 1997;25:786-795.
A Jesus, s Igor, I Fernando, et al. 2015 ISAKOS Biennial Congress ePoster #1321: MRI Study of Changes in Muscle Volume in ACL Reconstructed Knees Following Conventional or Accelerated Rehabilitation Programmes. Clínica San Miguel / Sports Medical Study and Research Center, Pamplona, Navarra, Spain
Beynnon BD, Johnson RJ, Naud S, et al. Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind investigation evaluating knee joint laxity using roentgen stereophotogrammetric analysis. Am J Sports Med. 2011 Dec;39(12):2536-48.
Pilot P, Bogie R. Draijer WF, et al. Experience in the first four years of rapid recovery; is it safe? Injury. 2006; 37 Suppl 5:S37-40.
Brownstein, B., Bronner, S. Patella fractures associated with accelerated ACL rehabilitation in patients with autogeneous patella tendon reconstructions. Journal of Orthopaedic and Sports Physical Therapy. 1997;26:168–172.
De Carlo, M., Klootwyk, T.E., Shelbourne, K.D. ACL surgery and accelerated rehabilitation: Revisited. Journal of Sport Rehabilitation. 1997;6:144–156.