Rehabilitation following knee surgery. Recommendations

Abstract

Satisfactory results following knee surgery can be obtained only through the combined efforts of the surgeon, patient and therapist. A rehabilitative plan is based upon consideration of the effects of disuse and immobility on musculoskeletal tissues, and knowledge of the healing requirements following injury and specific surgical procedures. A balance must be made between simultaneous demands for protection against undue stress to facilitate healing and the need for stress to retard atrophy of musculoskeletal tissue. A thorough review of these concepts forms the basis for a rational approach to rehabilitation after specific surgical procedures. The phasic approach to knee rehabilitation is based upon progression in a logical fashion through the chronology of immobility, range of motion, progressive weight bearing and strengthening exercises. The latter category can be subdivided into its own progression from isometrics, isotonics, functional exercises through isokinetics. The ultimate goal and final phase is a safe return to full activity. By integrating a thorough knowledge of the healing parameters of musculoskeletal tissues and the simultaneous coexisting needs for protection and controlled stress, specific rehabilitative programmes can then be designed for the most common surgical procedures including: anterior and posterior cruciate ligament reconstruction, meniscal repair and meniscectomy, lateral release and hyaline cartilage procedures.