Postoperative anterior cruciate ligament rehabilitation: A survey in Gauteng, South Africa.
Colett Robbertse, Vaneshveri Naidoo
PMID 40950565WHAT IT FOUND
Most Gauteng physiotherapists claim to use accelerated ACL rehab, but only 20% follow the actual protocol.
Practice varies widely: 66% start after surgery rather than before, and 59% use braces for 4-6 weeks despite evidence against routine bracing.
Key findings
01While 70% of participants stated they use an accelerated protocol, only 20% adhered to the specific criteria defined in the literature.
0266% of therapists commenced rehabilitation post-operatively, and 59% reported using range-of-motion braces for 4-6 weeks, both practices contrasting with current evidence recommendations.
03Myofascial release was the most frequently used modality (73%), and isometric exercises were started within the first week by 88% of participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had a low response rate and used convenience sampling, meaning the 56 participants may not represent all physiotherapists in the region. The survey was limited to one province in South Africa, restricting the generalisability of the findings to other contexts. The study did not collect data on surgical factors, graft types, or psychological variables, which significantly influence rehabilitation decisions and outcomes. Participants included physiotherapists with various special interests, not exclusively those specialising in ACL rehabilitation, potentially diluting the specific expertise reflected in the responses.
Declared interests
The research received no specific funding from any agency. No other conflicts of interest are declared.
The easy way to misread this
Do not assume that identifying as an 'accelerated' protocol user means your practice aligns with the evidence-based definition. Only 20% of those who claimed to use accelerated rehab actually followed the specific parameters, with many still using braces or delaying weight-bearing in ways that contradict the accelerated model.