The knee joint is a ligament guided and muscular stabilized joint. Therefore the rupture of the anterior cruciate ligament (ACL) causes a functional deficit with change of the knee kinematics and the dynamic muscle stabilization. The muscular dysfunction can be the result of inadequate muscle strength, a neuro-muscular control defizit, a propriozeptive dysfunction or often the combination of these causes. Due to the complex anatomy of the ACL an exact, patient specific operative anatomical reconstruction is not possible. Therefore we suggest primarily a conservative therapeutic approach. If this approach fails the reconstruction will be performed after the first rehabilitation phase. Independently from the conservative or surgical approach, the rehabilitation program consists of four function-based phases and the overall therapy goal is to achieve the same or even higher activity level than before the lesion.
Georg Thieme Verlag KG Stuttgart, New York.