One of the main priorities after ACL reconstruction is to regain the knee range of motion. This along with establishing a good strengthening program is usually best done two to three times per week for the first four to six weeks. Because many insurance policies will not cover this many visits to the therapist, an independent home program may need to be instructed earlier. Compliance in performing the exercises in and out of the clinic is the key.

The anterior cruciate ligament, or ACL, is one of four major ligaments in the knee that provide stability to the joint. When a patient sustains a tear to the ACL, a sensation of instability, or giving out, may develop in the injured knee. In order to restore stability to the knee, your doctor may recommend an ACL reconstruction to insert a new ligament in the place of the damaged ACL.

Early surgical intervention to repair a torn ACL is not recommended in the vast majority of cases, and physiotherapy for at least four to six weeks is almost always recommended first in the amateur sportsperson. This approach has the advantage of allowing any other associated injuries to settle, and any inflammation to subside. Taking time to have physiotherapy also gives the patient and physiotherapist the opportunity to assess whether they feel there is a genuine need for reconstruction.

Compared with surgery for meniscal tears, ACL reconstruction is a much more involved procedure as it involves taking a tendon graft as indicated (usually the hamstring) from another part of the leg and using this to substitute the broken ligament. The time taken to recover from this type of surgery is much longer than for meniscal tears, and it may take up to nine months before you are able to undertake full sporting activities again.

Yes, you will have either outpatient or in-home physical therapy. Patients are encouraged to utilize outpatient physical therapy. The Total Joint Care Coordinator will help you arrange for an outpatient physical therapy appointment. If you need home physical therapy, we will arrange for a physical therapist to provide therapy at your home. Following this, you may go to an outpatient facility three times a week to assist in your rehabilitation.

Musculoskeletal injuries typically respond very well to physical therapy, and the therapy usually accelerates recovery and the restoration of function. Athletics require a high-level function. Therapy to reduce pain, restore motion and strength, and recondition the body facilitates a timely and safe return to participation.

Most ACL reconstruction surgeries are done using a single-bundle reconstruction. A single-bundle ACL reconstruction uses a tendon graft to replace the torn ACL. Unfortunately, ACL tears cannot be repaired, or sewn together, and a graft must be used to reconstruct the ligament. When the ACL is reconstructed, the graft is placed in the position of the anteromedial bundle. Grafts are held in place by making a hole in the bone called a tunnel. One tunnel is made in the femur and one in the tibia.

Instead of placing just one larger graft, the double-bundle ACL reconstruction procedure uses two smaller grafts. Therefore, there are essentially two ligament reconstructions, one for each bundle. The double-bundle procedure requires two additional bone tunnels to accommodate a second graft, and one additional incision. Studies have demonstrated some advantages of the double-bundle ACL reconstruction.

This is a new procedure, and as is the case with any new procedure, the long-term results are not well understood. It is possible that this procedure will be an improvement on the standard single-bundle ACL reconstructions, but it is also possible that these patients may have the same, or even worse, long-term results. No one really knows just yet. The double-bundle is technically more demanding of a procedure, and there are fewer surgeons with experience in this surgical technique.

It is not clear that the double-bundle ACL reconstruction is a better procedure, but some patients are willing to try a new procedure in an effort to possibly improve their long-term result. Standard single-bundle ACL reconstructions have excellent results, with about 90% of patients able to return to activities at their pre-injury level. However, the results are not 100%, and some patients have persistent instability after ACL reconstructions, and may develop problems later in life.

A graft is the tissue we will use to give you a new ACL. The choices available break down into two large categories. Autograft, your own tissue; or allograft, cadaveric tissue. If you elect to utilize your own tissue, the three grafts available are bone-patella tendon-bone grafts, quadriceps tendon grafts, and hamstring grafts. There are many different allografts available to reconstruct the ACL.

Unless the surgeon advises otherwise, most people return to enjoying both of these sports with the use of a brace. However, remember every individual injury is different. Following the recommendations of the surgeon is of utmost importance.

Yes, both are essential for recovery. The number of physical therapy sessions varies for each patient, but exercise must be a lifetime commitment. Your surgeon and physical therapist will design an exercise program for you.

You may continue or discontinue physical after your 1 month postoperative appointment based on your comfort. TKR patients not getting a minimum flexion of 110 or extension of -5 will need to continue physical therapy.

Technically no. Both the therapists at Sandy Physical Therapy have received advanced training and certification that allows them to see patients without a referral from a physician. However, most insurance companies will not pay for physical therapy unless ordered by a doctor. Contact your insurance company to see if they require a doctor's referral. <back to top>

If you have a recurrent problem after your discharge from physical therapy, you may need to return for additional care. As a general rule, if it has been more than 30 days since you were last seen at our office, you will require an initial evaluation. This is to ensure that we have the latest findings and have determined the best treatment approach for your condition. You can either see your doctor to obtain a new prescription for physical therapy or call and ask him/her to fax it to our office.