ACL Reconstruction: Which Additional Physiotherapy Interventions Improve Early-Stage Rehabilitation? A Systematic Review

Abstract

Despite the restoration of the mechanical stability of the knee joint after ACL reconstruction (ACLR), patients often experience postoperative limitations. To our knowledge, there are no systematic reviews analyzing additional physiotherapy interventions implementing standard rehabilitation programs in the early postoperative phase after ACLR. The objective of this study was to analyze the additional physiotherapy interventions implemented in standard rehabilitation programs that improve early-stage ACLR rehabilitation. For this systematic review, we followed the PRISMA guidelines. In March 2022 we conducted a literature review using electronic databases. Primary outcomes were pain, edema, muscle strength, ROM, and knee function. The risk of bias and scientific quality of included studies were assessed with the RoB 2, ROBINS-I and PEDro scale. For the review, we included 10 studies that met the inclusion criteria (total n = 3271). The included studies evaluated the effectiveness of Kinesio Taping, Whole-body vibration, Local Vibration Training, Trigger Point Dry Needling, High Tone Power Therapy, alternating magnetic field, and App-Based Active Muscle Training Program. Most of the additional physiotherapy interventions improved pain, edema, ROM, knee muscle strength, or knee function in early-stage postoperative ACL rehabilitation. Except for one study, no adverse events occurred in the included studies, which demonstrates the safety of the discussed physiotherapy interventions. Further in-depth research is needed in this area.

What is the impact of Kinesotaping on anterior cruciate ligament reconstruction: a systematic review and meta-analysis.

“…Previous studies on Kinesio taping and anterior cruciate ligament reconstruction (ACLR) have provided some insights into its effectiveness, but none of them conducted a comprehensive analysis like the present meta-analysis. One previous systematic review discussed kinesotaping along with additional physiotherapy interventions, but it did not include any analysis (20). This gap in the literature prompted the need for a meta-analysis to evaluate the speci c effects of Kinesio taping compared to standard physiotherapy in ACLR patients.…”

Anterior Cruciate Ligament Reconstruction and Return to Sports: A Comprehensive Guide

“…Van Grinsven et al suggests that an expedited treatment plan, which does not involve the use of postoperative bracing and instead prioritizes pain reduction, swelling, inflammation, restoration of range of motion, enhancement of strength, and improvement of neuromuscular control, offers significant benefits without compromising stability [32]. Kochman et al conducted a systematic analysis review to examine the incorporation of supplementary physiotherapy interventions within conventional rehabilitation protocols following ACLR [33]. The review encompassed a total of ten studies that assessed the efficacy of several therapies, including Kinesio Taping, Whole-body vibration, Local Vibration Training, Trigger Point Dry Needling, High Tone Power Therapy, alternating magnetic field, and App-Based Active Muscle Training Program [33].…”

“…Kochman et al conducted a systematic analysis review to examine the incorporation of supplementary physiotherapy interventions within conventional rehabilitation protocols following ACLR [33]. The review encompassed a total of ten studies that assessed the efficacy of several therapies, including Kinesio Taping, Whole-body vibration, Local Vibration Training, Trigger Point Dry Needling, High Tone Power Therapy, alternating magnetic field, and App-Based Active Muscle Training Program [33]. The majority of these therapies show enhancements in pain reduction, reduction of swelling, increased range of motion (ROM), improved knee muscle strength, or enhanced knee function after postoperative rehabilitation for anterior cruciate ligament (ACL) injuries [33].…”

“…The review encompassed a total of ten studies that assessed the efficacy of several therapies, including Kinesio Taping, Whole-body vibration, Local Vibration Training, Trigger Point Dry Needling, High Tone Power Therapy, alternating magnetic field, and App-Based Active Muscle Training Program [33]. The majority of these therapies show enhancements in pain reduction, reduction of swelling, increased range of motion (ROM), improved knee muscle strength, or enhanced knee function after postoperative rehabilitation for anterior cruciate ligament (ACL) injuries [33]. The study conducted by Sasaki et al examined the impact of an 8-week core-muscle training regimen on the neuromuscular control of the lower limb and trunk during jump landing and single-legged squatting [34].…”

Nordic hamstring exercises in functional knee rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomised, controlled study

“…Arthroscopic reconstruction of the ACL and early postoperative intervention in rehabilitation are now commonly used methods to consolidate surgical results and improve knee function after ACL rupture. Complications such as knee pain, combined dysfunction, oedema and muscle atrophy often occur in the post-operative period, so a good post-operative training system is needed to help patients recover 4 , 5 . Studies have shown that post-operative rehabilitation greatly influences the final outcome of surgery and that muscle strength rehabilitation is an important component of post-operative rehabilitation for ACL reconstruction 6 .…”