Editorial Commentary: Early Home Exercises and Formal Physical Therapy After Anterior Cruciate Ligament Reconstruction Are Optimal to Prevent Arthrofibrosis.

Abstract

Arthrofibrosis after anterior cruciate ligament reconstruction can be a devastating complication. Female sex, older age, elevated blood glucose levels, and concomitant procedures may increase the risk. Preoperative exercise programs including formal physical therapy are recommended if patients lack full extension preoperatively. After surgery, accelerated rehabilitation programs are associated with lower rates of arthrofibrosis, including those with a higher frequency or intensity of rehabilitation. Early rehabilitation has also been associated with achievement of improved postoperative outcomes. Our practice is to recommend that preoperative patients have a normalized gait, full extension, a mobile patella, and comfortable flexion within 20° of that of the contralateral knee prior to reconstruction. After surgery, patients start a home exercise program on day 0 and begin early physical therapy as soon as reasonably possible.