Rehabilitation after posterior cruciate ligament reconstruction: a review of the literature and theoretical support
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Arthroscopy and Sports Medicine
Rehabilitation after posterior cruciate ligament reconstruction: a review of the literature and theoretical support Jin Goo Kim · Yong Seuk Lee · Byung Se Yang · Soo Jin Oh · Sang Jin Yang
Received: 21 June 2013 © Springer-Verlag Berlin Heidelberg 2013
Abstract Introduction The purpose of this study was to conduct a literature review of studies that have addressed rehabilitation after posterior cruciate ligament (PCL) reconstruction. In particular, we intended to perform categorical analysis and discuss some critical points. Materials and methods A literature review of English language articles was performed using the PubMed databases. Our literature search was performed using the following text words: [posterior cruciate ligament OR PCL] AND [reconstruction] AND [rehabilitation]. A total of 34 articles met our criteria and were included in the final systematic review. Rehabilitation protocols were reviewed and tabulated according to main rehabilitation protocol categories [range of motion (ROM), weight bearing, bracing, and strengthening]. Results Ranges of motion of 90° and 120° were allowed at 4–8 and 6–12 weeks postoperatively in 70 % of studies. Full weight bearing was delayed until 6 weeks postoperatively in 60 % of studies. Most studies (73 % of studies) used a brace for 6–8 weeks and active hamstring exercise was not allowed for 6–24 weeks postoperatively. Conclusions The review showed that flexion of 90° was allowed at around 6 weeks and prone passive flexion exercise or supine passive ROM exercise with posterior support was
J. G. Kim · B. S. Yang · S. J. Oh · S. J. Yang Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, Seoul, Korea Y. S. Lee (*) Department of Orthopedic Surgery, Gil Hospital, Gil Medical Center, Gachon University School of Medicine, Gachon University, 1198 Guwol‑dong, Namdong‑gu, Incheon 405‑760, Korea e-mail: [email protected]
used to prevent a posteriorly directed force. Most authors used non-weight bearing or partial weight bearing in their rehabilitationprograms, however it may be possible to perform active weight bearing in fullextension or early flexion grades as soon as the soft tissue situation allows. Costrengthening exercises could be recommended because these exercises produce co-contraction between the quadriceps and hamstring muscles with little posterior shear force. Keywords Posterior cruciate ligament · Rehabilitation protocol · Literature review · Theoretical support
Introduction There is a paucity of information on rehabilitation after reconstruction of the posterior cruciate ligament (PCL), and there is a lack of consensus in the literature regarding the rehabilitation protocol and different protocols have been proposed [11, 14, 34, 41]. With regard to PCL outcomes, an improved understanding of rehabilitation may be a critical factor in terms of restoring knee function [14]. However, studies that have addressed to this topic rarely provide a rationale for the protocols used [11, 26, 34]. This implies th
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