Delayed versus Accelerated Weight-bearing Rehabilitation Protocol Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.
Zheyuan Fan, Jingtong Yan, Zhongsheng Zhou and 6 others
PMID 35037693WHAT IT FOUND
Accelerated weight-bearing after ACL reconstruction improved IKDC scores but increased knee laxity and bone tunnel widening.
Lysholm, Tegner, and KOOS scores showed no difference. The authors recommend delayed weight-bearing to restore knee stability.
Key findings
01Meta-analysis revealed that accelerated weight-bearing improved IKDC scores compared to delayed weight-bearing.
02Accelerated weight-bearing was associated with more significant knee laxity and bone tunnel enlargement.
03There was no statistical difference between the groups in Lysholm, Tegner, or KOOS scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was considerable heterogeneity in the included studies regarding graft choice, specific rehabilitation protocols, and follow-up times. The study could not determine the optimal timing for starting weight-bearing training due to these variations. Follow-up periods may have been too short to capture long-term adverse effects of increased knee laxity, such as osteoarthritis.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that improved IKDC scores in the accelerated group indicate a superior overall outcome. The meta-analysis shows that this comes at the cost of increased knee laxity and bone tunnel widening, leading the authors to recommend delayed weight-bearing for better stability.