General principles:

– Revalidation after the ACL reconstruction is adapted to the type of graft used for reconstruction

– Pre-operative preparation has its importance because a well-prepared knee before intervention is mandatory,in order to achieve a good surgical outcome.

– A reconstruction with a patellar tendon (Kenneth Jones) gives a deficit of extension between 60 and 95° at low concentric velocity; a reconstruction with ischio-calf graft leads to a deficitof the eccentric flexors with high velocity, always between 60 and 95°. Muscle strengthening should consider these differences to correct specific deficits.

– For decades, closedchain exercises were preferred to openchain exercises. It has been demonstrated that these exercises are not responsible for a large anterior tibial translation, and there is no big difference between closedchain closed and openchain exercises. In other words, openchain exercises are allowed with certain restrictions, to complement classical closedchain exercises.

– The type of exercise patients should do at home should be well thought out. Physical therapist should not require patients to work a muscle group if it was not previously worked in the kinesiotherapy sessions.

– The physical therapist has to assess the quality of exercises in the rehabilitation room before allowing patients to carry out exercises at home alone.

– Additional precautions will be taken when usingischio-calf grafts, because these muscles must rest for six weeks, and their toning should be left at last (to allow healing after tendinous grafting).

– Proprioception should start soon after the surgery. It can continue for a year.

– Sports resumption is considered after 6 to 9 months after the ACL reconstruction (depending on the sport: for football and rugby six months for amateurs and nine months for professionals)

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