CoChat
Sign Up
Cited by 303Knee injuries and reconstruction techniquesSports injuries and preventionTendon Structure and Treatment

Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction

Open access
Kotsifaki, Roula, Korakakis, Vasileios, King, Enda, Barbosa, Olivia, Maree, Dustin, Pantouveris, Michail, Bjerregaard, Andreas, Luomajoki, Julius +2 more·2023·British Journal of Sports Medicine
DOI 10.1136/bjsports-2022-106158PMC PMC11785408
Open this paper in CoChat — free accountOpen PDF

Abstract

This guideline was developed to inform clinical practice on rehabilitation after anterior cruciate ligament reconstruction (ACLR) and was performed in accordance with the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) instrument and used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A Guideline Development Group systematically searched and reviewed evidence using randomised clinical trials and systematic reviews to evaluate the effectiveness of rehabilitation interventions and guide clinicians and patients on the content of the optimal rehabilitation protocol after ACLR.The guideline targets patients during rehabilitation after ACLR and investigates the effectiveness of the available interventions to the physiotherapist, alone or in combination (eg, exercise, modalities, objective progression criteria). Exercise interventions should be considered the mainstay of ACLR rehabilitation. However, there is little evidence on the dose-response relationship between volume and/or intensity of exercise and outcomes. Physical therapy modalities can be helpful as an adjunct in the early phase of rehabilitation when pain, swelling and limitations in range of motion are present. Adding modalities in the early phase may allow earlier pain-free commencement of exercise rehabilitation. Return to running and return to training/activity are key milestones for rehabilitation after ACLR. However, there is no evidence on which progression or discharge criteria should be used.While there is a very low level of certainty for most components of rehabilitation, most of the recommendations provided in this guideline were agreed to by expert clinicians. This guideline also highlights several new elements of ACLR management not reported previously.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bjsports-2022-106158

Cites

175 of 175 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Gluteus maximus controls hip adduction and internal rotation, motions known to contribute to patellofemoral joint stress and PFP.

    “During the acute phase, gluteus maximus activation should be emphasized as this muscle controls hip adduction and internal rotation, motions known to contribute to patellofemoral joint stress and PFP.43,44”

    From A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice. (2024) · cites this paper as [43]

    The Results sections on Exercise initiation and Strength and motor control training discuss early quadriceps and hamstring strengthening, motor control, and anterior knee pain; page numbers were not available in our copy. Searches for gluteus maximus, hip adduction and internal rotation, and patellofemoral joint stress found no passage addressing the claimed mechanism or recommendation to emphasize gluteus maximus activation. (LLM, conf=0.74)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. [30]Reddy DVS, Kamath SU, Annappa R, et al. Does preoperative rehabilitation give better short term results in anterior cruciate ligament reconstruction. Ambul Surg 2020; 26: 40– 3.
  2. [105]Salvarani A, Agosti M, Zanre A, et al. Mechanical vibration in the rehabilitation of patients with reconstructed anterior cruciate ligament. Eur Medicophysica 2003; 39: 19.
  3. [164]Papandreou MG, Papaioannou N, Antonogiannakis E, et al. The effect of cross exercise on quadriceps strength in different knee angles after the anterior cruciate ligament reconstruction. Braz J Biomotricity 2007; 1: 123– 38.
  4. [168]Li J, Xie X. Effects of core-stability training on gait improvement in patients after anterior cruciate ligament reconstruction. Int J Clin Exp Med 2019; 12: 5731– 7.

Cited by

Sorted by citations

Related

Authors
Kotsifaki, R., Korakakis, V., King, E., Barbosa, O., Maree, D., Pantouveris, M., Bjerregaard, A., Luomajoki, J., Wilhelmsen, J., & Whiteley, R.
Affiliations
Qatar Orthopaedic and Sports Medicine Hospital (QA)
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2023-02-02
Volume
57
Issue
9
Pages
500-514
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2022-106158
PMC
PMC11785408
OpenAlex
W4318972952
Cited by
303
References
175
Citations by year
2026: 106 · 2025: 122 · 2024: 51 · 2023: 23
FWCI
80.62
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Sports Medicine (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
Aspetar Orthopaedic and Sports Medicine Hospital
Topics
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
Keywords
anterior cruciate ligament reconstruction, rehabilitation, exercise therapy, physical therapy modalities, return to running, return to training, exercise dose-response, knee rehabilitation
MeSH terms
Anterior Cruciate Ligament Injuries, Exercise Therapy, Humans, Exercise, Physical Therapy Modalities, Anterior Cruciate Ligament Reconstruction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review