Anterior Cruciate Ligament Reconstruction Rehabilitation: MOON Guidelines

Overview

Journal Sports Health

Publisher Sage Publications

Specialty Orthopedics

Date 2015 Jul 2

PMID 26131301

Citations 83

Authors

Rick W Wright

Amanda K Haas

Joy Anderson

Gary Calabrese

John Cavanaugh

Timothy E Hewett

Dawn Lorring

Christopher McKenzie

Emily Preston

Glenn Williams

Affiliations

Soon will be listed here.

Abstract

Context: Anterior cruciate ligament (ACL) reconstruction rehabilitation has evolved over the past 20 years. This evolution has been driven by a variety of level 1 and level 2 studies.

Evidence Acquisition: The MOON Group is a collection of orthopaedic surgeons who have developed a prospective longitudinal cohort of the ACL reconstruction patients. To standardize the management of these patients, we developed, in conjunction with our physical therapy committee, an evidence-based rehabilitation guideline.

Study Design: Clinical review.

Level Of Evidence: Level 2.

Results: This review was based on 2 systematic reviews of level 1 and level 2 studies. Recently, the guideline was updated by a new review. Continuous passive motion did not improve ultimate motion. Early weightbearing decreases patellofemoral pain. Postoperative rehabilitative bracing did not improve swelling, pain range of motion, or safety. Open chain quadriceps activity can begin at 6 weeks.

Conclusion: High-level evidence exists to determine appropriate ACL rehabilitation guidelines. Utilizing this protocol follows the best available evidence.

Citing Articles

Investigating the Impact of Preoperative Kinesiophobia and Pain on Postoperative Gait Biomechanics Following Anterior Cruciate Ligament Injury.

Lisee C, Baez S, Bjornsen E, Thoma L, Blackburn T, Spang J Orthop J Sports Med. 2025; 13(2):23259671241301376.

PMID: 40034608 PMC: 11872735. DOI: 10.1177/23259671241301376.

A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Nervous System.

Chaput M, Ness B, Lucas K, Zimney K Int J Sports Phys Ther. 2025; 17(1):47-59.

PMID: 39974283 PMC: 11837868. DOI: 10.26603/001c.30020.

Anterior Cruciate Ligament Tears among Football Players.

Rund J, Christensen G, Fleming J, Wolf B Curr Rev Musculoskelet Med. 2025; .

PMID: 39930256 DOI: 10.1007/s12178-025-09952-z.

Analysis of Limb Loading and Lower Extremity Strength Recovery Across Time After Anterior Cruciate Ligament Reconstruction.

Bruce Leicht A, Thompson X, Queen R, Rodu J, Higgins M, Cross K Sports Health. 2024; :19417381241285859.

PMID: 39397655 PMC: 11556615. DOI: 10.1177/19417381241285859.

Lower limb coordination patterns following anterior cruciate ligament reconstruction: A longitudinal study.

Armitano-Lago C, Bjornsen E, Lisee C, Buck A, Buttner C, Kiefer A J Sport Health Sci. 2024; 14:100988.

PMID: 39299606 PMC: 11863276. DOI: 10.1016/j.jshs.2024.100988.

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