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Team Approach: Return to Play After Anterior Cruciate Ligament Reconstruction

Wang, Dean, MD1; Chiaia, Theresa, PT, DPT1; Cavanaugh, John T., PT, MEd, ATC, SCS1; Rodeo, Scott A., MD1

doi: 10.2106/JBJS.RVW.18.00003
Team Approach Review Articles

  • * Current surgical and rehabilitation techniques have allowed for a relatively high rate of return to sports after anterior cruciate ligament (ACL) reconstruction. Although some patients may be expected to return to sporting activities by as early as 8 months after the surgical procedure, most patients will have not achieved the appropriate rehabilitation benchmarks by this time point and can require as long as 2 years to reach their full preoperative level.
  • * In addition to the diagnosis and surgical treatment of the ACL injury, the surgeon has to educate the patient about the injury, treatment, and rehabilitation process.
  • * The physical therapist commonly spends the most time with the patient and therefore must foster a relationship of trust early on with the patient-athlete. Through biomechanical evaluations, factors that contributed to the ACL injury and ongoing deficits during the rehabilitation process are identified and are addressed.
  • * Assessment of movement quality complements the traditional quantitative measures of performance and informs the medical and rehabilitation team, as well as the patient, of the presence of potentially faulty movement patterns associated with an ACL injury.
  • * Throughout the course of rehabilitation, the certified athletic trainer works closely with the physical therapist to ensure athlete compliance with the prescribed exercises. Communication between the physical therapist and the certified athletic trainer therefore plays an integral role in the patient’s rehabilitation. During the return-to-play phase of rehabilitation, the certified athletic trainer serves as the liaison between the patient, surgeon, physical therapist, and coaching staff.
  • * This team approach to managing the athlete’s injury, rehabilitation, and expectations is key to a successful outcome.

1Sports Medicine and Shoulder Service (D.W. and S.A.R.) and Sports Rehabilitation and Performance Center (T.C. and J.T.C.), Hospital for Special Surgery, New York, NY

E-mail address for S.A. Rodeo:

Investigation performed at the Sports Medicine and Shoulder Service and the Sports Rehabilitation and Performance Center, Hospital for Special Surgery, New York, NY

Disclosure: There was no source of external funding for this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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