subject: Physical Therapy Continuing Education: Return to Play Following ACL Surgery [print this page] Physical Therapy Continuing Education: Return to Play Following ACL Surgery
In our series of Physical Therapy continuing education interview series we recently had a chance to speak with a well known orthopedic surgeon. He is what he said about returning to play post ACL reconstruction.
ACL Surgeon: Return to sport, I think there has been a push to get people back sooner and sooner, but realistically I think, although I've had many people back at four months, realistically I think it does take five to six months to really get back and be safe about getting back. Even with the best therapy and the best patient, I don't think you need to hurry this in a time frame that puts you at risk. So, I think that's important to know. And if you use an allograft is takes even longer. It can take longer for tissue to heal within the tunnels.
PhysicalTherapyContinuingEducation.Org: Very good. In fact, that was going to be my next question about returning to play. Do you find is there much difference between say hamstring graft versus a patellar tendon graft?
ACL Surgeon: You know I really haven't seen any. I think both really, with the right rehab, they can get back in an appropriate amount of time and again that goes back to my earlier statement that talked about the position of the graft. That's probably more important than the type of the graft, particularly when you're using a graft from your own body, meaning autograft, or patellar tendon or hamstring. That getting that graft in the right position and with the right fixation, then the next thing is the right rehabilitation and then return to play really I think are pretty equal.
Now, if you do have a meniscus tear or something that requires a repaired meniscus, not a trimming out but an actual stitching the meniscus, that's going to delay things. We've seen that people are going to take a little bit longer with that because there's more time on crutches, there's less things that can be done early on in the rehabilitation that just delays the overall recovery. So, that's an important factor to remember.
And there may be other issues too, such as cartilage injuries in the knee, things that may keep somebody on crutches longer, may delay the weight bearing status, and those tend to delay the overall recovery as well.
PhysicalTherapyContinuingEducation.Org: Gotcha. So, from your standpoint, you know as a therapist we see someone on a pretty regular basis, you see them more in a snapshot of their progress over time. Is there any advice or anything you see that you could share with the rehab professional, either common mistakes they make or something you think you would like to see them do a little bit better, whether that be more aggressive, less aggressive, anything that you might have noticed over the years?
ACL Surgeon: I really appreciate the physical therapist that has an understanding of the rehabilitation of an ACL. If I have a protocol, which I do, and I appreciate when they will follow what I'm trying to do. Now, a protocol or a guideline is just that. It's a guideline. You have to be able to adapt from that, so I can also appreciate those that are able to look at the patient, look at the guidelines, but say, "Okay, we got a little bit different situation here and we need to adapt this a little bit differently." And then communicate with me with what they're seeing.
