"The most important thing for ACL surgery patients is to start physical therapy early and rigorously," says Rick W. Wright, MD, in a Medical News Today article about his systematic review published in Journal of Bone and Joint Surgery. "It can be difficult at first, but it's worth it in terms of returning to sports and other activities."

Wright and his colleagues in the Department of Orthopedic Surgery at Washington University School of Medicine identified 85 articles on treatment following reconstructive ACL surgery from 2006 to 2010 through multiple search engines. Twenty-nine Level-I or II studies met inclusion criteria and were evaluated with use of the CONSORT (Consolidated Standards of Reporting Trials) criteria. The authors included studies on postoperative bracing, accelerated strengthening, home-based rehabilitation, proprioception and neuromuscular training, and 6 miscellaneous topics investigated in single trials.

The authors also found that bracing following ACL reconstruction is not beneficial, but home-based rehabilitation can be successful. Neuromuscular interventions, while not harmful to patients, are not likely to yield large improvements in outcomes and should not be performed to the exclusion of strengthening and range-of-motion exercises. Vibration training may lead to faster and more complete proprioceptive recovery, but further evidence is needed.