Overview of Anterior Cruciate Ligament Rehabilitation and its Evolution in Hong Kong in the Past 8 Years

Abstract 

Rehabilitation protocols for injuries to the anterior cruciate ligament (ACL) change rapidly. The first local study was conducted 8 years ago, and there is a need to review our local practice in order to evaluate our services. Questionnaires were sent to local hospitals and rehabilitation centres asking about their management regimens for ACL cases from 1 January to 31 December 2003. Most (89.3%) ACL injuries occurred during sports, with 74.1% in males aged 18-30 years. Thirty-four centres returned answered questionnaires, of which only 28 contained valid answers; 21 centres (75%) had a defined rehabilitation protocol for surgical cases but only 10 (35.7%) had a defined protocol for non-surgical cases. Patients were usually managed with patella tendon or hamstring autografts, and 25% of the centres had separate rehabilitation protocols for these grafts. Local protocols were comparable to the accelerated rehabilitation programme for patella tendon autografts, except that they showed slower progress in agility training and return to sports. The protocols for hamstring autografts were generally in line with overseas programmes, but started hamstring exercises earlier. The timing of muscle training and sports-specific activities varied among centres. Treatment outcome might be improved by therapists spending more time with patients. Compared with the previous study, more centres had defined rehabilitation protocols for surgical ACL cases, but not for non-surgical cases. The practice of ACL rehabilitation in Hong Kong is generally comparable to that reported from overseas.

Key words:  physiotherapy , knee , anterior cruciate ligament , injury , management

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