Cheng-Yen Chan, MD
Resident Physician
National Taiwan University Hospital
Taipei City, Taipei, Taiwan (Republic of China)
Alan C. Chang, MD
Resident Physician
National Taiwan University Hospital
Irvine, California, United States
Chueh-Hung Wu, MD, PhD
Medical Director
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch
Taipei City, Taipei, Taiwan (Republic of China)
Levent Özçakar, MD
Professor
Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine (PRM), Ankara, Turkey
Ankara, Ankara, Turkey
The primary repair of the anterior cruciate ligament (ACL) has re-emerged as a viable treatment option for acute ruptures. Rehabilitation following ACL reconstruction or primary repair is essential for returning patients to their baseline activities. While numerous studies have investigated rehabilitation after ACL reconstruction, few have focused on primary repair. This scoping review aims to: (a) describe the rehabilitation protocols for primary ACL repair reported in the literature, and (b) identify knowledge gaps and differences between primary ACL repair and reconstruction to offer directions for future clinical research.
Design: A scoping review design was selected due to the descriptive and exploratory nature, aiming to identify and map available research evidence from various databases relevant to the research question. Evaluation of study quality and risk of bias is not required and does not impact the outcome in scoping reviews.
Results: A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science identified a total of 66 studies involving over 3,100 participants, using keywords related to primary ACL repair and rehabilitation protocols. No randomized controlled trials directly comparing postoperative rehabilitation protocol were identified. Eight items of the rehabilitation protocol were analyzed, based on existing clinical practice guidelines for ACL reconstruction. This review highlights the inadequacy and heterogeneity of the available data.
Conclusions: This scoping review revealed a lack of adequate and consistent evidence for rehabilitation protocols following primary ACL repair in current literature. As ACL repair techniques gain popularity, it is essential for experts to collaborate in developing optimal, technique-specific rehabilitation guidelines. Clinical trials are necessary to investigate appropriate and validated rehabilitation strategies for these patients, with or without concomitant injuries. The findings also suggest that transparent reporting and further analysis of procedure-specific rehabilitation protocols after primary ACL repair are needed in future studies.Â
