Objective
To compare the outcomes of a 6-month-long accelerated rehabilitation with a 12-month-long rehabilitation. There is no consensus on the optimal duration of rehabilitation after anterior cruciate ligament reconstruction (ACLR). Trends in the past decades have shifted towards accelerated programs, often resulting in a return to play (RTP) at 4–6 months, postoperatively. However, longer rehabilitation cycles have recently experienced renaissance due to a greater understanding of graft remodeling.
Methods
Adult athletes who underwent ACLR between 2015 and 2018 by the same surgeon were included and followed-up prospectively for 24 months. Participants were allocated into two groups based on their RTP (6 months vs. 12 months) and compared with graft elongation, reoperation rate, and sports career (quit or continue) outcomes.
Results
Fifty-four patients underwent accelerated rehabilitation and 92 completed conventional rehabilitation. The accelerated rehabilitation was significantly associated with graft elongation—the accelerated rehabilitation group (n=9) and the conventional rehabilitation group (n=0), p<0.001—and need for reoperation—the accelerated rehabilitation group (n=5) and the conventional rehabilitation group (n=1), p=0.026. Although the relationship between rehabilitation time and quitting competitive sports did not reach significance at 0.05 level (p=0.063), it was significant when p<0.1, thereby showing a clear trend.
Conclusion
Accelerated rehabilitation increased graft elongation risk. Knee laxity ≥3 mm measured at 6 months after ACLR should be accompanied by RTP time frame re-evaluation. Arthrometry checkups or routine magnetic resonance imaging shortly after RTP may be considered in cases of accelerated rehabilitation.

Citations

• Movement Assessments as Predictors for Initial Anterior Cruciate Ligament Injury: A Critically Appraised Topic
  Destinee Johnson, Rebecca Maldonado, Erin Lally
  Journal of Sport Rehabilitation.2025; : 1.     CrossRef
• Anterior cruciate ligament reconstruction in the elderly: 5-Year follow-up study
  Takayuki Kurokawa, Károly Csete, Péter Jávor, Lilla Sándor, Bálint Baráth, Helga Holovic, László Török, Petra Hartmann
  Injury.2024; 55: 111529.     CrossRef
• Blood Flow Restriction Training and Its Use in Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis
  Jamaal Butt, Zubair Ahmed
  Journal of Clinical Medicine.2024; 13(20): 6265.     CrossRef
• Reasons for the Variability of Rehabilitation Programs and the Perspective of the Standardized Guidelines Development for Patients after Anterior Cruciate Ligament Reconstruction
  V.V. Kotiuk, O.O. Kostrub, I.A. Zasadniuk, D.O. Smirnov, V.A. Podik, R.I. Blonskyi
  TERRA ORTHOPAEDICA.2023; (3(118)): 64.     CrossRef

Citations

• Uncovering the “riddle of femininity” in osteoarthritis: a systematic review and meta-analysis of menopausal animal models and mathematical modeling of estrogen treatment
  G. Gilmer, A.C. Bean, H. Iijima, N. Jackson, R.C. Thurston, F. Ambrosio
  Osteoarthritis and Cartilage.2023; 31(4): 447.     CrossRef
• Face and Predictive Validity of MI-RAT (Montreal Induction of Rat Arthritis Testing), a Surgical Model of Osteoarthritis Pain in Rodents Combined with Calibrated Exercise
  Colombe Otis, Emilie Bouet, Sokhna Keita-Alassane, Marilyn Frezier, Aliénor Delsart, Martin Guillot, Agathe Bédard, Jean-Pierre Pelletier, Johanne Martel-Pelletier, Bertrand Lussier, Francis Beaudry, Eric Troncy
  International Journal of Molecular Sciences.2023; 24(22): 16341.     CrossRef
• Chondroprotective and antiarthritic effects of galangin in osteoarthritis: An in vitro and in vivo study
  Xiaojian Huang, Wenbin Pei, Bowei Ni, Rui Zhang, Hongbo You
  European Journal of Pharmacology.2021; 906: 174232.     CrossRef
• Nano-ligament combined with sports rehabilitation training on the therapeutic effect after ligament reconstruction
  Yuntao Zhou, Zheng Zhou
  Ferroelectrics.2021; 579(1): 56.     CrossRef
• The miR-1906 mimic attenuates bone loss in osteoporosis by down-regulating the TLR4/MyD88/NF‐κB pathway
  H. Xie, L. Cao, L. Ye, G. Shan, W. Song
  Physiology International.2021; 107(4): 469.     CrossRef
• Tenascin-C expression controls the maturation of articular cartilage in mice
  Bastian L. Gruber, Michael J. Mienaltowski, James N. MacLeod, Johannes Schittny, Stephanie Kasper, Martin Flück
  BMC Research Notes.2020;[Epub]     CrossRef
• Development and characterization of various osteoarthritis models for tissue engineering
  Ji Eun Kim, Da-hyun Song, Soo Hyun Kim, Youngmee Jung, Sang Jun Kim, Mikko Juhani Lammi
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• mTOR‐mediated inactivation of 4E‐BP1, an inhibitor of translation, precedes cartilage degeneration in rat osteoarthritic knees
  Olga Katsara, Victoria Kolupaeva
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• Lower range of molecular weight of xanthan gum inhibits cartilage matrix destruction via intrinsic bax-mitochondria cytochrome c-caspase pathway
  Xintian Shao, Qixin Chen, Xixi Dou, Lei Chen, Jixu Wu, Wei Zhang, Huarong Shao, Peixue Ling, Fei Liu, Fengshan Wang
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Objective
To evaluate and compare protein expression profiles of synovial fibroblasts using proteome analysis in swine knee injuries with joint instability, during early post-traumatic arthritis (PTA) development. Method: Experimental PTA was induced by transection of the anterior cruciate ligament (ACL) in swine left knee joints. After sacrifice at 8 weeks, cartilage and synovium obtained from both knee joints were prepared for histopathologic examination. Cultured synovial fibroblasts were processed for 2-dimensional electrophoresis and mass spectrometric analysis. Histopathologic examination showed overt arthritic changes that supported the development of early PTA. Results: Proteome analyses led to the identification of more than 1,500 protein spots and of 11 differently expressed protein spots. Of those, six proteins were down-regulated (cytoskeletal β actin, cofilin-1, destrin, Rho GDP dissociation inhibitor α, and unnamed protein product), and five proteins were up-regulated (α-B crystallin, smooth muscle protein 22-α, and cytoskeletal β actin) in ACL-transected synovial fibroblasts. That is, proteins related to cellular organization and signal transduction are down-regulated, and those related to cell rescue, defence, and stress are up-regulated. Conclusion: These results may suggest that joint instability contributes to the development of PTA and is one of the major etiologic factors of PTA. In addition, this suggests that the proteome analysis of synovial fibroblasts is a useful approach in examining a joint after an injury and can be used to understand the pathogenesis of PTA. (J Korean Acad Rehab Med 2007; 31: 447-456)

Objective
To evaluate effect of comprehensive rehabilitation treatment after reconstruction of anterior cruciate ligament (ACL). Method: We reviewed the medical records of 10 patients who had been in rehabilitation program after reconstruction of ACL. We measured the range of motion of the knee joint, pain intensity by visual analogue scale (VAS) score, the difference of thigh circumference between normal and reconstructed legs, strength of flexors and extensors of the knee, and functional test before and after rehabilitation. Results: The range of motion, VAS score, thigh circumference, strength of flexors and extensors of reconstructed knee were significantly improved after rehabilitation. The knee flexion angle increased from 86.5^o to 135^o and knee extension angle increased from ⁣9.61^o to 0^o. VAS score decreased from 3.8 to 1.2. The thigh circumference just above patella decreased from 38.6 cm to 36.5 cm. The torque of flexors increased from 66.2 N·m to 128.7 N·m and that of extensors at 60^o/sec increased from 110.5 N·m to 201.2 N·m. 8 out of 10 players returned to sports successfully after systemic rehabilitation. Conclusion: We suggested systemic and appropriate rehabilitation after ACL reconstruction for successful return to sports. (J Korean Acad Rehab Med 2005; 29: 624-629)