Defining an Accelerated Rehabilitation Protocol Following Anterior Cruciate Ligament Reconstruction: A Scoping Review.

Background and

Objectives

Accelerated rehabilitation after anterior cruciate ligament reconstruction (ACLR) is widely implemented, yet its definition and distinguishing characteristics remain inconsistently described in the literature. This scoping review examined how accelerated rehabilitation after ACLR is defined, described common protocol features, and identified elements distinguishing it from conventional rehabilitation. Materials and

Methods

A scoping review was conducted using systematic searches of Medline (PubMed), Embase, and Web of Science from 1 April 1967 to 26 October 2025. Studies including patients aged 16 years or older who underwent primary ACLR that reported any form of accelerated rehabilitation or early progression relative to conventional protocols were eligible for inclusion.

Results

Of 6002 screened records, 64 studies met the inclusion criteria. Accelerated rehabilitation was consistently characterized by early restoration of knee range of motion, early full weight-bearing, rapid gait normalization, early initiation of closed and open kinetic chain exercises, and avoidance of prolonged immobilization. However, definitions varied substantially across studies. Substantial heterogeneity was observed in progression timelines, bracing and crutch use, and return-to-sport criteria.

Conclusions

Accelerated rehabilitation after ACLR appears to represent a brace-free, criterion-based, function-oriented approach emphasizing early restoration of knee extension, progressive loading, and individualized progression rather than simply shortened timelines. Establishing consensus definitions and standardized reporting is necessary to improve comparability across studies and facilitate translation into clinical practice.