Total Rupture of the Anterior Cruciate Ligament: Testing of Function, Rehabilitation, and Long Term Implications

Rupture of the anterior cruciate ligament (ACL) is a serious knee injury that annually affects approximately 4000 individuals in Norway; of which about fifty percent go through reconstructive surgery. An ACL rupture may lead to instability and poor knee function. In the long term, the injury may permanently preclude return to previous activity level and pose an increased risk for later development of knee osteoarthritis. Today, no definite guidelines for the best treatment and rehabilitation after ACL-rupture exist; neither for non-operative treatment or rehabilitation after reconstruction. In this article we present our rehabilitation protocol for ACL injured patients treated at Hjelp24 NIMI/NAR. Based on our own principles, we then address important aspects physiotherapists should be aware of when involved in ACL rehabilitation: Advantages and possible pitfalls related to reconstruction, expected function after rehabilitation, whether we should recommend the patient to return to his or her previous level of activity or not, and risk factors for the development of knee osteoarthritis.