POSTOPERATIVE REHABILITATION PROTOCOLS AND FUNCTIONAL RECOVERY IN ATHLETES FOLLOWING ACL RECONSTRUCTION

Abstract

Anterior cruciate ligament (ACL) reconstruction remains one of the most common procedures performed in athletes, yet postoperative functional recovery varies widely depending on rehabilitation progression, neuromuscular adaptation, and individual biomechanical responses. This multi-center prospective study evaluated postoperative rehabilitation protocols and their impact on functional outcomes across 120 competitive athletes following ACL reconstruction. Quantitative measures—including strength symmetry indices, hop performance metrics, range of motion (ROM) progression, and Functional Recovery Index (FRI) scores—were collected over a 12-week period, complemented by qualitative assessments of athlete-reported pain, confidence, and return-to-sport (RTS) readiness. Results demonstrated significant improvements in quadriceps strength symmetry, dynamic stability, and hop distance by Weeks 6 to 10, with athletes achieving measurable gains in knee flexion and extension ROM. FRI scores showed consistent upward trajectories, indicating progressive restoration of functional capacity. Pain levels decreased substantially, whereas psychological readiness improved, emphasizing the role of both physical and mental rehabilitation components in recovery. Correlation analysis revealed strong associations between strength symmetry, ROM gains, hop performance, and overall functional recovery. Athletes who followed structured, phase-based rehabilitation protocols demonstrated superior outcomes compared to those with inconsistent adherence. These findings highlight the critical importance of early neuromuscular training, progressive loading, and standardized RTS criteria in optimizing postoperative recovery. The study reinforces that comprehensive, evidence-based rehabilitation protocols not only accelerate functional gains but also enhance long-term athletic performance and reduce reinjury risk. Overall, this research advances the understanding of postoperative ACL rehabilitation by identifying key functional predictors, highlighting effective recovery strategies, and providing data-driven recommendations for clinical and sports-performance settings.