Rehabilitation Clinical Trial
Official title:
Post-operative Rehabilitation Protocol for Combined Reconstruction of Anterior Cruciate Ligament and Anterolateral Knee Ligament Surgery
Introduction: Individuals with an ACL lesion present abnormal rotational stability. Among the structures located in the anterolateral region of the knee that could act as restraints of the rotational knee lassitude, there is the Anterior Lateral Ligament (ALL), and its reconstruction associated with ACL reconstruction could reduce recurrence injury rates. Objective: to develop a rehabilitation protocol for patients undergoing combined reconstruction of ACL and ALL. METHOD: Articles published with patients submitted to ACL reconstruction with an anatomic technique and flexor tendon graft, (which is the same one adopted in this study), were selected as a base to this protocol. Discussion: The results will provide important information on clinical practice, since it can help identify the necessity or not of restraining the knee range of motion in combined surgeries. It can guide the therapeutic planning, including the cost of knee restraint devices, in addition to estimating these patients prognosis. The protocol with partial restriction of knee range of motion in the first 6 weeks of postoperative is the most indicated program in the rehabilitation of the combined surgeries of ACL and ALL reconstruction.
Currently, the anatomical reconstruction of the ACL has been widely used, with the purpose of
increasing the knee rotational control after the injury, and thus, to improve the clinical
evolution in the long term. The concept involves restoring knee kinematics by improving
function by reducing the number of graft failures, delaying or preventing degeneration of the
joint. Normally, rehabilitation protocols in these cases are more careful with respect to
knee ROM gain and use of exercises in open kinetic chain, with the purpose of preserving the
graft.
Allied to this concept, the use of extra-articular reconstruction associated with ACL
reconstruction, gained new horizons with the discovery of ALL, signaling to the possibility
of a better rotational control and, consequently, a decrease in the number of graft failures.
Due to the particularities of each surgical technique, it is necessary that the
rehabilitation protocols adapt to the different methods, guaranteeing the functional
recovery, but without damages to the reconstruction.
With the proposal of ACL reconstruction surgery associated with ALL reconstruction, it is
necessary to develop a specific rehabilitation protocol for these patients, considering some
postoperative specificities of extra-articular reconstructions, since they are data that are
not available in the literature until now.
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