Postoperative Rehabilitation of Posterior Cruciate Ligament Surgery: A Systematic Review

Background: Injuries to the posterior cruciate ligament (PCL), while less common than anterior cruciate ligament (ACL) injuries, can significantly impact the stability and function of the knee. Surgical intervention, particularly isolated PCL reconstruction (PCLR), is often essential for severe injuries. However, the outcomes of PCLR are frequently less satisfactory compared to ACL surgeries, with suboptimal rehabilitation protocols identified as a potential contributing factor. This systematic review aims to consolidate the existing literature on postoperative rehabilitation following PCLR, highlighting variations in rehabilitation practices and their implications for patient outcomes. Methods: This review includes a comprehensive analysis of the published scientific literature between ۲۰۰۵ and ۲۰۱۸, detailing rehabilitation protocols for isolated PCLR. A total of ۴۴ articles were included based on stringent inclusion criteria. Key aspects examined included weight-bearing recommendations, range of motion (ROM) guidelines, brace usage, specific exercise regimens, and criteria for returning to sports activities. Data were also categorized to identify common themes and discrepancies in rehabilitation practices. Results: Findings revealed significant diversity in rehabilitation protocols following PCLR. Weight-bearing recommendations varied from immediate full weight-bearing to restrictions lasting up to ۱۲ weeks. Most articles (۴۲ out of ۴۴) supported the use of postoperative bracing, generally maintaining the knee in full extension for varying durations, while ۳۰ articles provided insights on ROM activities, with notable discrepancies regarding the timing and progression of these exercises. Recommendations for returning to sports activities differed widely, ranging from four to twelve months’ post-surgery. Important to note, only a small portion of the reviewed literature included objective performance criteria to guide progress in rehabilitation stages. Conclusion: This review emphasizes the lack of consensus on optimal postoperative rehabilitation strategies following PCLR. The significant variation in protocols suggests that current practices may not be sufficiently evidence-based and could potentially impact recovery and patient outcomes. Therefore, there is an urgent need for further research to establish standardized rehabilitation guidelines that incorporate objective criteria for progression and address the diverse needs of patients recovering from PCLR.

کلیدواژه ها:

PCL reconstruction ، postoperative rehabilitation ، physical therapy ، knee function ، sports recovery