Featured KCBJ Problem: The ACL Tear, part 4: The Recovery
“ACL is torn! Out for the year!” How many times have you heard that on ESPN? Have you also heard “Oh, he came back too fast and re-tore.” That last statement makes us wince…..twice.
You have had ACL reconstruction, either by autograft (with your own tissue) or allograft (with someone else’s) and you are most likely wrapped up in a thick dressing and wondering what your knee looks like under there. The surgeon has done his work and now it is up to you.
A focused rehabilitation is necessary, Dr. Thomas Samuelson,MD, a sports medicine physician here at Kansas City Bone and Joint took some time with us to answer several questions about rehabilitation of the ACL.
Question 1: Most of your patients are active and want to get back to that lifestyle as soon as possible. What is the common time frame that they should expect for return to competitive sports?
Dr. Samuelson: 6-9 months
Question 2: It has been said that physical therapy after an ACL reconstruction is lengthy, how long is the course of formal therapy and what are your expected outcomes?
Dr.Samuelson: Therapy begins immediately following surgery and continues for up to 4-6 months to allow for progressive improvement in motion, strength and endurance. The protocol is detailed, and in later months includes running, agility training and sports specific exercise with the goal of returning to full activity upon completion of the program.
Question 3: Competitive athletes want to get back to their sport right away as mentioned above. What are your words of wisdom to help them understand the importance of safe return?
Dr. Samuelson: The ACL graft takes time to mature, independent of how a patient is progressing in physical therapy. Studies have shown that it is only at approximately 50% strength at 3 months out from surgery, and only at 80% strength at 9 months removed from the surgery. Athletes must be protected during this window of recovery in order to minimize the risks of re-injury.
Question 4:What is the one thing that your tend to tell your patients regarding their postoperative recovery?
Dr. Samuelson: Rehabilitation is as an important element of the ACL recovery as the surgery itself.