Surgeon suggests bypassing physical therapists, claiming patients regain motion easier at home.
- from ORTHOPEDICS TODAY 2006; 26:66
Home-based rehabilitation for ACL reconstruction patients leads to outcomes as good or better than standard physical therapy-supervised programs.
That view comes from Stephen M. Howell, MD, who thinks ACL reconstruction patients can rehabilitate most effectively at home with a simple exercise program. Most patients can also skip bracing, which Howell said does more harm than good in these cases.
…
Physical therapists (PTs) can do a great job, said Howell, adding however that he too often sees anterior knee pain in his ACL reconstruction patients resulting from certain knee extension exercises done in therapy.
For starters, he recommends patients do a series of simple, open-chain exercises at home, wherein a patient props up in bed and uses a rolled up towel under the end of their foot or below their knees to slowly flex or extend.
…
The merits of bracing the operated knee remain controversial. Howell does not think post-ACL reconstruction brace use is effective. A brace tells a patient, “… they can’t use their leg, they can’t put weight on it. It’s a negative thought and it ends up giving them some atrophy. So, eliminate the bracing — it’s ineffective and detrimental,” Howell told the group. “Custom and off-the-shelf braces are not protective [of a new ACL graft], and they cause thigh atrophy” (Risberg 1999 and Moller 2001).
read the rest of this enlightening article about ACL operation
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