Turkish Journal of Physical Medicine and Rehabilitation 2013 , Vol 59 , Num 2
The Gulhane Anterior Cruciate Ligament Rehabilitation Protocol Following Anterior Cruciate Ligament Reconstruction Surgery
İlknur Tuğcu 1 ,Fatih Tok 2 ,Bilge Yılmaz 1 ,M. Ali Taşkaynatan 3 ,A. Salim Göktepe 4 ,Haydar Möhür 4 ,Kamil Yazıcıoğlu 5 ,Ahmet Özgül 6
1 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi, Ankara, Türkiye
2 İskenderun Military Hospital, Physical Medicine and Rehabilitation Service, Hatay, Turkey
3 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
4 Gulhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, Ankara, Turkey
5 Gülhane Askeri Tıp Akademisi Türk Silahlı Kuvvetleri Rehabilitasyon Merkezi, Ankara
6 GATA Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
DOI : 10.4274/tftr.69345

Objective: A well-planned post-operative rehabilitation protocol is as important to the final outcome after anterior cruciate ligament (ACL) reconstruction as the surgery itself. The aim of the present study was to investigate whether a comprehensive approach to acute post-operative rehabilitation -the Gulhane ACL Rehabilitation Protocol- significantly affected post-operative outcome in ACL reconstruction cases over a 13- week period.

 

Materials and Methods: This prospective clinical trial included 58 male patients who underwent unilateral, arthroscopically assisted ACL reconstruction with a bone-patellar tendon-bone graft. A KAT (Kinesthetic Ability Trainer) 2000 balance system was used to quantify balance performance of the lower extremities 2 days before surgery and 13 weeks post-surgery. Additionally, isokinetic tests were performed at the same time points, and knee and thigh (5 cm, 10 cm, and 15 cm above the patella) circle measurements were obtained in both legs 1, 6, and 13 weeks post-surgery.

 

Results: The mean age of the patients was 26.63 years. In all, 31 patients had right and 27 patients had left ACL reconstruction. There was significant improvement in dynamic balance scores from pre-op to post-op (p<0.05). There were significant decreases in extensor peak torque scores at 60°s-1 and 180°s-1 in the operated legs (p=0.042 and p=0.007, respectively). There were significant decreases in the thigh circle 5 cm and 10 cm above the patella 6 weeks post-surgery and significant increases at 10 cm and 15 cm above the patella 13 weeks post-surgery in the operated legs (p<0.016).

 

Conclusion: The Gulhane ACL Rehabilitation Protocol could be used following ACL reconstruction.

Keywords : Anterior cruciate ligament, rehabilitation, protocol