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Document Title: BarberWestin-AJSM-Jan99.shtml
Article Title: The Effect of Exercise and Rehabilitation on Anterior-Posterior Knee Displacements After Anterior Cruciate Ligament Autograft Reconstruction
Authors: Sue D. Barber-Westin, Frank R. Noyes, MD, Timothy P. Heckmann, PT, AT, C and Brian L. Shaffer
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: January 1999
Volume 27, Number 1, pages 84-93
Keywords: rehabilitation, ACL reconstruction, exercise, autografting.
(Figures included. Reference-denoting numbers appear in the same point size as the document text.)
Comments: This superb article is a classic in the field of ACL-reconstruction rehabilitation. It illustrates the importance of proper rehabilitation and well-chosen exercises to optimal recovery. It also shows that, for evaluating an ACL-reconstructed knee, more than just KT-1000/2000 arthrometer measurements are needed.
ABSTRACT
We studied the effect of rehabilitation strength training and return to activities on anterior-posterior knee displacements after patellar tendon autogenous anterior cruciate ligament reconstruction. A total of 938 measurements were sequentially collected for 142 patients with the KT-2000 arthrometer. Rehabilitation included immediate knee motion and early weightbearing, light sports at 6 months, and competitive sports at 8 months or later. At a minimum of 2 years after surgery, 121 patients (85%) had normal displacements (less than 3 mm of increase at 134 N), 14 (10%) had 3 to 5.5 mm of increase (partial function), and 7 (5%) had more than 5.5 mm of increase (failed). There was no association found between the initial onset of the abnormal displacements in the 21 knees and either the amount of time after surgery or the rehabilitation program. Six of the seven grafts that failed did so in the 1st postoperative year. Serial displacement measurements allow early detection of graft stretching and subsequent modification of rehabilitation or delay in return to strenuous activities. These measurements showed that the rehabilitation program used in this study was not itself injurious and resulted in an acceptable failure rate of 5%.
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