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ABSTRACT

Rehabilitation after ACL (anterior cruciate ligament) recon-struction has drastically changed over the last decade, with the adoption of a more aggressive approach, right from the first day after surgery. Progress in the effectiveness of rehabilitation is based on improvements in operative techniques, as well as on the encouraging results of histological studies regarding graft healing. Despite a huge amount of research papers on this topic, a rehabilitation golden standard still has not been established, due to the complexity of this problem. In this review, we point out the basic principles of rehabilitation after arthroscopically assisted ACL reconstruction based on actual practices, as well as the importance of specific procedures for the prevention of complications during the postoperative peri-od. The importance of range-of-motion exercises, early weight bearing, an appropriate gait scheme, patella mobilisation, pain and oedema control, as well as stretching and balance

exer-cises is explained. The functional advantages of closed kinetic chain exercises, as well as their influence on the graft are also described, in comparison to open kinetic chain exercises. The fundamentals of returning to sports are revealed and the spe-cific aspects of rehabilitation regarding graft choice are point-ed out. While waiting for new clinical investigations, which are expected to enable the establishment of a rehabilitation golden standard, the outlined principles should be followed. The complexity of this injury requires treatment in highly spe-cialised institutions.

Key words: ACL; rehabilitation

Emilija DUBLJANIN-RASPOPOVIĆ Đorđa Radojlovića 29, 11000 Beograd Tel.: 011 367 0710

E-mail: zulekule@net.yu

BASIC PRINCIPLES OF AGGRESSIVE REHABILITATION AFTER ANTERIOR

CRUCIATE LIGAMENT RECONSTRUCTION

Emilija DUBLJANIN-RASPOPOVIĆ1_{, Marko KADIJA}2_{, Dragana MATANOVIĆ}1 1_{Centre for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Belgrade;} 2_{Institute of Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia, Belgrade}