Once surgical reconstruction is elected, the rehabilitation goals and their rationale are discussed. A booklet covering the same information is given to patients to review at home. To facilitate rehabilitation during the first postoperative week, we request that caregivers assisting patients after surgery be present during educational sessions. Once swelling has resolved and full motion has returned, surgery can be scheduled around school, work, and social schedules. Each phase of rehabilitation is carried out at home.
Postoperative rehabilitation consists of two parts.
The first part of rehabilitation focuses on returning the knee to a quiescent state by eliminating hemarthrosis and pain while achieving full knee motion. The second part of rehabilitation involves donor-site strengthening, first with full flexion exercises to pull the patellar tendon to length, then with repetitive strengthening exercises to stimulate tendon regrowth. The first part of rehabilitation takes precedence over donor-site strengthening because aggressive strengthening may cause painful swelling that may limit motion. Week 1 Postsurgery Hemarthrosis control. To prevent hemarthrosis, a cold compression cuff is placed on the ACL-reconstructed knee immediately after the wounds are closed and a light dressing is applied.