Effect of An Accelerated Rehabilitation Program After Anterior Cruciate Ligament Reconstruction with Hamstring Tendons: Results Of 59 Cases Followed Up For 19 Months

Abstract

Introduction: Application of accelerated rehabilitation procedures after anterior cruciate ligament reconstruction using hamstring tendons haven't yet been accepted. We aimed to show the results of four phase accelerated rehabilitation protocol in anterior cruciate ligament reconstruction using quadrupled semitendinosus graft.
Patients and methods: We have recorded stability tests, Lysolm knee scores, range of motion of the knee, thigh circumferences and activity level on 59 patients whose mean age was 28±8,4 and followed up for 19 months. Continuous passive motion hasn't been used in this four phase accelerated rehabilitation protocol. Patients were allowed to do closed kinetic chain exercises, early weight loading, and range of motion exercises.
Results: Instability recurred in four patients. Impingement was interpreted as the causative factor of these cases with instability. Mean Lysolm knee score was 53 preoperatively, and 87 postoperatively. While 93% of patients could make moderate or strenuous activities before injury, in the postoperative period this ratio was 81%. We didn't encounter any significant loss in range of motion.
Conclusions: As a result we propose the following: 1. To prevent impingement and instability recurrence, anterior tibial tunnel placement must be avoided. 2. Although it is known that there are more safe zones, when accelerated rehabilitation protocols are implemented after anterior cruciate ligament reconstruction using bone-patellar tendon-bone. Accelerated rehabilitation protocols can be used after anterior cruciate ligament reconstruction using hamstring tendons. 3. Early functional results are encouraging. We believe that usage of continuous passive motion may not be absolutely necessary after longer follow up.