Rehabilitation after posterior cruciate ligament reconstruction: a review of the literature and theoretical support.
BACKGROUND
The purpose of this study was to conduct a literature review of studies that have addressed rehabilitation after posterior cruciate ligament (PCL) reconstruction. In particular, we intended to perform categorical analysis and discuss some critical points.


METHODS
A literature review of English language articles was performed using the PubMed databases. Our literature search was performed using the following text words: [posterior cruciate ligament OR PCL] AND [reconstruction] AND [rehabilitation]. A total of 34 articles met our criteria and were included in the final systematic review. Rehabilitation protocols were reviewed and tabulated according to main rehabilitation protocol categories [range of motion (ROM), weight bearing, bracing, and strengthening].


RESULTS
Ranges of motion of 90° and 120° were allowed at 4-8 and 6-12 weeks postoperatively in 70 % of studies. Full weight bearing was delayed until 6 weeks postoperatively in 60 % of studies. Most studies (73 % of studies) used a brace for 6-8 weeks and active hamstring exercise was not allowed for 6-24 weeks postoperatively.


CONCLUSIONS
The review showed that flexion of 90° was allowed at around 6 weeks and prone passive flexion exercise or supine passive ROM exercise with posterior support was used to prevent a posteriorly directed force. Most authors used non-weight bearing or partial weight bearing in their rehabilitation programs, however it may be possible to perform active weight bearing in full extension or early flexion grades as soon as the soft tissue situation allows. Co-strengthening exercises could be recommended because these exercises produce co-contraction between the quadriceps and hamstring muscles with little posterior shear force.
Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, Seoul, Korea.
Jin Goo
JG
Kim
Yong Seuk
YS
Lee
Byung Se
BS
Yang
Soo Jin
SJ
Oh
Sang Jin
SJ
Yang
D001915:Braces; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000534:rehabilitation*; D016474:Weight-Bearing