Exploring Rehabilitation Protocols for Primary Anterior Cruciate Ligament Repair: Insights from a Scoping Review

Alan Chang; Cheng-Yen Chan; Meng-Tin Lin; Chueh-Hung Wu; Levent Özçakar

doi:10.1097/PHM.0000000000002681

Exploring Rehabilitation Protocols for Primary Anterior Cruciate Ligament Repair: Insights from a Scoping Review

Am J Phys Med Rehabil. 2025 Jan 3. doi: 10.1097/PHM.0000000000002681. Online ahead of print.

Authors

Alan Chang¹, Cheng-Yen Chan¹, Meng-Tin Lin², Chueh-Hung Wu, Levent Özçakar³

Affiliations

¹ Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
² Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.

PMID: 39750028
DOI: 10.1097/PHM.0000000000002681

Abstract

Objectives: The primary repair of the anterior cruciate ligament (ACL) has re-emerged as a treatment for acute ruptures. While numerous studies have investigated rehabilitation after ACL reconstruction, few have focused on primary repair. We aimed to describe the rehabilitation protocols for primary ACL repair, and to identify knowledge gaps and differences between primary ACL repair and reconstruction.

Design: A scoping review design was selected due to the descriptive and exploratory nature, aiming to identify and map available research evidence from various databases relevant to the research question. Evaluation of study quality and risk of bias is not required in scoping reviews.

Results: A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science identified a total of 66 studies involving over 3,100 participants. No randomized controlled trials directly comparing postoperative rehabilitation protocol were identified. Eight items of the rehabilitation protocols were analyzed, based on existing clinical practice guidelines for ACL reconstruction. This review highlights the inadequacy and heterogeneity of the available data.

Conclusions: This review revealed a lack of consistent evidence and call for the development of standardized, technique-specific rehabilitation guidelines after primary ACL repair. Clinical trials and transparent reporting are needed to establish validated protocols.