Shelbourne 1995
- noticed patients noncompliant with their rehab protocol were doing much better
- looked at what noncompliant patients were doing
- what they were doing was advancing activities as tolerated
Reviewed results of accelerated rehabilitation
- fewer ruptures with better ROM
Major recommendations
Natural History of ACL deficient knee is variable
- functional instability 15% - 90%
- progression to OA is variable
Depends on level of patient demands / activity
1. Late meniscal injury in ACL deficient knee
15-25%
2. Function
Daniels Am J Sports Med 1994
- 292 ACL defecients knees
Developmental Anatomy
Knee joint first appears as a mesenchymal cleft at 8 weeks gestation
- ACL and PCL separate entities by week 10