ACLR Rehabilitation and Function Checklists for Return to Play

February 21, 2019


One of the most common injuries that occurs during non-contact sport is a tear of the ACL, a crucial ligament in the twisting, turning and pivoting that many non-contact sport requires.  The (American Academy of Orthopaedic Surgeons) AAOS has approved Appropriate Use Criteria (AUCs) for anterior cruciate ligament (ACL) injury prevention programs and treatment, as well as rehabilitation and function checklists to help guide and ensure a safe return to sports for the treated athlete.

Here we list out the 6 major issues and clinically evidence support for assisting ACLR patients trying to return to previous activity level.

Explore sections below to learn more...

Postoperative Rehabilitation

Outlines the postsurgical protocol, from early range of motion, weight bearing and closed and open chain quad and hamstring therapy, to rehabilitative bracing and neuromuscular stimulation to prevent autogenic muscle inhibition (AMI) and atrophy.

1. Why functional brace for ACLR RTS - AAOS Systematic Review

Functional Bracing After ACLR: A Systematic Review

Lowe WR, et al J Am Acad Orthop Surg. 2017 Mar;25(3):239-249.

Dr Walt Lowe's over 25 years of experience with Donjoy

Conclusion and author's recommendation:

The authors prefer their patients to use postoperative functional bracing during physical activity for 6 - 12mo after RTS to protect healing tissues, to reduce kinesiophobia, and to facilitate return to previous levels of competition.

  • improve knee kinematic & gait kinetic
  • improve proprioception
  • Protect the graft
  • More confidence – reduced kinesiophobia
  • facilitate fast RTS/RTP

2. Tunnel osteolysis

Tunnel osteolysis post-ACLR: a systemic review examining select diagnostic modalities, treatment options and rehabilitation protocols.

Bhullar R, et al, Knee Surg Sports Traumatol Arthrosc. 2019 Feb;27(2):524-533.

Group of Orthopedic Sports Medicine Doctors Testimonies of XROM Knee

Conclusion and author's recommendation:Extension locking bracing had the lowest tunnel widening of all the brace protocols, including no brace.

3. Symmetry < 10% difference between injured & non-injured sides

Hop testing symmetry improves with time and while wearing a functional knee brace in ACLR athletes

Peebles AT, et al Clin Biomech (Bristol, Avon). 2019 Dec;70:66-71.

Conclusion and author's recommendation: The results support using a functional brace during athletic activities for improving symmetry in the early RTS period.

Watch this video to learn about the importance of Symmetry before RTS

4. Quad : Ham Ratio< 1.5 : 1

Study on 3D kinematics and electromyography of ACLD knee participants wearing a functional knee brace during running

Théoret D, et al, Knee Surg Sports Traumatol Arthrosc. 2006 Jun;14(6):555-63.

Conclusion and author's recommendation: Muscle activity showed consistent trend to increase for the hamstrings and decrease for the quadriceps.

5. Dynamic stability, posture

The effect of proprioceptive knee bracingon knee stability after ACLR

Hanzlíkováac I, et al, Gait & Posture. 2019Jan;67:242-247.

An exploration of the use of IMU in the assessment ofdynamic postural control of the knee and the effect of bracing and taping

Budini A, et al, GPhysiotherapy Practice and Research 39, 2018July; 91-98.

Conclusion and author's recommendation: Muscle wearing a Reaction brace significantly improvedrotational knee control during a sport-specific (pivot turn jump) task andhence can reduce the risk factors for reinjury.

6. Psychological Readiness to RTS Scale (confidence kinesiophobia)

External supports improve knee performance in ACLRindividuals with higher kinesiophobia levels.

Harput G, et al. Knee. 2016 Oct;23(5):807-12.

Conclusion and author's recommendation:
The Donjoy Drytex Economy Hinged Knee brace is auseful option to assist ACLR individuals in overcoming kinesiophobia duringreturn to preinjury activity level and/or sport. When compared withkinesiotaping, the brace appeared to be more effective at enhancing kneestrength and selfreported knee function.

Supplementary Materials

Product Brochures mentioned in above clinical evidence papers can be downloaded here:

print pattern repeat
Donjoy Post-op ROM brace

print pattern repeat
Chattanooga NMES

print pattern repeat
Chattanooga Active-K

print pattern repeat
Donjoy ACL Functional brace

print pattern repeat
Donjoy Trizone - compression sleeve

Chattanoga Lightforce

print pattern repeat
OA Reaction - ACLR early OA

Enovis Managing ACL Injuries

Previous Related Webinars:

Post ACLR: Improving Loading Symmetry & Neuromuscular Training for Safe Return To Sports

print pattern repeat

How to RTS from ACL injury? part 1 (English subtitle) [前十字韌帶受傷後如何重返運動? 上集]

print pattern repeat

How to RTS from ACL injury? Part 2 (Chinese with English subtitle) [前十字韌帶受傷後如何重返運動? 下集]

ACADEMY | Leading educational content and training for your clinic
Contact your
local distributor

Enovis Asia-Pacific Ltd.

Unit 1905 19/F, Tower 2,
Grand Central Plaza,
138 Shatin Rural Committee Road,
Shatin, Hong Kong 🇭🇰

General Enquiry

+852 3105 1415

Recovery Science
Ms Crystal Leung

+852 3105 3723

Ms Joe Cheung

+852 3105 1415

Business Inquiry
Mr Stephen Chung

   stephen.chung[@]

© 2023 Copyright Enovis. All Rights Reserved.