I am seeing a physical therapist for rehab after having an ACL repair. Although I'm putting full weight on my leg, I notice some patients with the same surgery are limited in how much weight they are allowed to put on the leg. Why the difference?

The postoperative program for patients after an anterior cruciate ligament (ACL) repair may vary depending on a number of factors. First, different surgeons have different protocols for their patients.

Second, every surgery can be different. The amount of weight you can put through the operated leg and the exercises you do may depend on the type of graft used or the type of fixation method used to hold the graft in place.

It may also depend on any other surgical procedures carried out during the ACL repair. For example, if the meniscus (cartilage inside the joint) was torn, it may have to be repaired or shaved smooth.

Patients who have both the ACL and a meniscal repair are often only allowed to bear partial weight the first few weeks after surgery. The use of crutches and a brace may also vary from patient to patient based on these same considerations.

And finally, rehab with different therapists can sometimes result in different programs. If the knee is unstable or there are other problems, the therapist may advise a more cautious, less aggressive rehab program.

Reference: 

Gregory B. Maletis, MD, et al. A Prospective Randomized Study of Anterior Cruciate Ligament Reconstruction. In The American Journal of Sports Medicine. March 2007. Vol. 35. No. 3. Pp. 384-394.

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