Even during this time, a functional brace is still recommended. Some patients continue with a functional brace during activities up to 2 years postoperatively.
If your goal is to return to a high-level sport, then full speed running, cutting, high jumps, rebounds, long jumps, etc. should be trained and progressed towards during this time-frame.
No matter your goal, even if you have reached it, you need to continue to maintain the outcomes you have achieved to help avoid any risk of injury or re-rupture. Unfortunately, one of the risk factors for re-injury is time. As time goes on, your risk can increase, so it is essential to maintain what you have gained.
During this recovery stage, a full battery of tests can be performed to see if you are ready for a maximum return to your sport or activity. These tests may look different depending on where you go for rehabilitation, your goals, or what activities you may want to get back to.
But most tests have some requirements in common, including:
Both knees demonstrate an equal range of motion without pain;
Quadriceps strength comparison bilaterally is 80% or greater;
Hamstring to quadriceps ratio of the involved leg is 66-75% or greater;
Acceleration rate of at least .2 seconds; and
Functional hopping test comparison bilaterally is 85% or greater.
Ensuring you can hit the mark on all of these things, with adequate strength of surrounding muscles, good balance, and control of your body mechanics, should result in less risk of re-injury.
Unfortunately, the risk of re-rupturing the same ACL or even the opposite ACL does exist. Ensure you do everything you can to follow your Physical Therapist’s guidelines, recovery protocols, and maintain what you have gained.
Re-rupture is not the only risk that needs to be taken into consideration. Other risks include:
Arthrofibrosis: The knee joining capsule becomes chronically inflamed and thick. This happens if there is a lack of knee joint movement. Full immobilization is the worst thing you can do after ACL surgery.o avoid this, make sure to begin rehabilitation right away and begin weight-bearing with your crutches and your brace to promote healing.
Anterior Knee Pain: The front of your knee hurts, generally around your kneecap. This can occur if your ACL was reconstructed with a portion of your patella tendon. Or it can happen if you don’t adequately strengthen your quadriceps tendon. This is less serious than a re-rupture or arthrofibrosis. However, you still want to address this not to be affected by it throughout your full recovery.
Arthritis: Patients who have an ACL rupture, regardless of whether they have the ACL reconstruction surgery or not are at higher risk of development of knee arthritis. This is due to the damage of the cartilage of the knee at the time of injury.
The recovery throughout the first year after an ACL reconstruction is significant. It needs to be taken seriously, not just to avoid rupturing your new ACL but also to help you return to what you love. Don’t take the recovery lightly, and watch out for warning signs for any of these risks.