Table 1.
Summary of Included Studies' Recommendations on Rehabilitation Milestones and Timeframes following PCL Reconstruction
| Author, year | Level of Evidence* | Weight-bearing | Brace | Range of Motion | Hamstring | Running, agility, plyometrics | Return to Sport |
|---|---|---|---|---|---|---|---|
| Accadbled F et al., 2013 | IV | PWB initially; FWB by 9 wk | Long leg cast × 6 wk; hinged knee brace × 6 wk | Run: 6 mo | 9 mo | ||
| Adler GC. 2013 | IV | Extension brace × 1 wk | Delayed; > 1 wk | ||||
| Bovid KM et al., 2013 | IV | Early, limited and protected ROM | 9-12 mo | ||||
| Cavanaugh JT, 2015 | V | TTWB × 2 wk; PWB × 6 wk; FWB by 7 wk | Extension brace × 6 wk | Immediate; 0-90˚ | 6 wk (active) | Agility: 5 mo; Run: 4 mo‡; Plyo: 4 mo | 24 wk§ |
| Chahla J, 2016 | V | NWB × 6 wk; FWB by 7 wk | PCL brace (Jack brace or Rebound brace) × 6 mo† | Immediate; 0-90˚ | Agility: 6 mo; Run: 6 mo‡; Plyo: 6 mo | ||
| Chen & Gao 2009 | IV | WBAT | Extension brace × 4 wk | Delayed; > 5 wk | Run: 4 mo | ||
| Chuang TY et al., 2011 | IV | WBAT | Extension brace × 12 wk, unlocked | Delayed; > 4 wk | 9 mo | ||
| Deie M et al., 2015 | III | “Fixed” brace × 2 wk, PCL brace until 6 mo | Run: 6 mo | 10-12 mo | |||
| Eguchi A et al., 2014 | IV | NWB × 3 wk; PWB | Extension brace × 1 wk | Delayed; > 1 wk | Run: 4 mo | ||
| Fanelli GC et al., 2007 | V | NWB × 6 wk; PWB × 3 wk; FWB by 10 wk | Extension brace × 4 wk; unlocked 4-6 wk | Delayed; > 3 wk | 9-12 mo | ||
| Fanelli GC et al., 2009 | V | NWB × 5 wk; PWB × 4 wk; FWB by 10 wk | Extension brace × 5 wk; unlocked, d/c brace at 10 wk; PCL brace | Delayed; > 6 wk | Agility: 25 wk | 37 wk | |
| Fanelli GC et al., 2010 | V | NWB × 5 wk; PWB × 4 wk; FWB by 10 wk | Extesnion brace × 3 wk; unlocked | Delayed; > 4 wk | 6 mo (resisted OKC) | 6 mo | |
| Fanelli GC et al., 2010 | V | NWB × 5 wk; PWB × 4 wk; FWB by 10 wk | Extension brace × 5 wk, d/c brace at 10 wk; PCL brace | Delayed; > 5 wk | 9 mo | ||
| Fanelli GC et al., 2015 | V | NWB × 3 wk; PWB × 2 wk; FWB by 6 wk | Extension brace × 3 wk, d/c brace at 10 wk | Delayed; > 3 wk | 9 mo | ||
| Fanelli GC, 2008 | V | NWB × 6 wk; PWB × 3 wk; FWB × 10 wk | Extension brace × 3 wk; unlocked | Delayed; > 4 wk | 6 mo (resisted OKC) | 6 mo | |
| Garofolo R et al., 2006 | IV | NWB × 2 days; PWB × 7 wk; FWB by 8 wk* | Extension × 3 wk | Delayed; > 3 days | 3 mo (resisted OKC) | 9 mo | |
| Gill et al., 2012 | IV | PWB × 5 wk; FWB by 6 wk | Extension brace × 2 wk; unlocked, d/c brace at 6; functional brace at 12 | Immediate; passive | 18 wk | ||
| Giombini et al., 2007 | V | PWB × 4 wk; FWB by 5 wk | Extension brace × 2 wk; unlocked | Delayed; > 4 days | 12 wk (“actively put to work”) | Agility: 7 mo; Run: 5 mo‡; Plyo: 7 mo | 8 mo§ |
| Goudie et al 2010 | IV | TTWB × 6 wk; PWB × 3 wk; FWB by 10 wk | Extension brace | Immediate, auto-assisted ROM exercise | 3 - 9 mo | ||
| Hermans et al 2009 | IV | PWB × 7 wk; FWB by 8 wk | Brace locked in 15˚ flexion × 4 wk | Delayed; > 4 wk | 9 mo§ | ||
| Huang et al 2010 | IV | NWB × 2 wk; PWB × 3 wk; FWB by 6 wk | General: 3 mo; competitive: 4 mo | ||||
| Johnson, D 2009 | V | PWB × 5 wk; FWB by 6 wk | Extension splint immobilization | 12 mo | |||
| Kim et al 2009 | III | PWB × 6 wk; FWB by 7 wk | Extension brace × 2 wk; PCL brace × 6 wk | Delayed; > 2 wk | 6 mo | ||
| Lee & Jung 2013 | V | WBAT | Extension brace | ||||
| Li et al 2015 | IV | NWB × 6 wk; PWB × 5 wk; FWB by 12 wk | Extension brace × 4 wk, d/c brace at 12 wk | Immediate; 0-90˚ | 6 mo | 6 mo (light), 9 mo (full) | |
| Lim et al 2010 | III | PWB × 7 wk; FWB by 8 wk | Extension brace × 6 wk | Passive in prone | 4 mo | 9 mo | |
| Lim et al 2015 | III | PWB × 6 wk; FWB by 7 wk | Extension brace × 6 wk, d/c brace at 12 wk | Immediate; 0-90˚ | 12 wk | Run: 12 wk | 9 mo |
| MacGillivray JD et al., 2006 | III | TTWB × 4 wk; PWB × 2 wk; FWB by 7 wk | Extension brace × 4 wk | “Early post-operative period”: 0-90˚ (passive) | 9 mo | ||
| Maruyama et al 2012 | III | PWB × 2 wk; FWB by 3 wk | Extension brace | Run: 6 mo | 8 mo | ||
| Marx et al 2009 | V | PWB × 4 wk; FWB by 5 wk | Extension brace × 4 wk | Delayed; > 4 wk | 4 mo | Run: 6 mo | 9 mo |
| Puh et al 2014 | V | Extension brace × 4 wk; unlocked | Immediate; 0-90˚ (passive in prone) | ||||
| Quelard et al 2010 | IV | TTWB × 1 wk; PWB × 1 wk; FWB by 3 wk | Extension brace × 45 days | Immediate; 0-90˚ | 6 mo (resisted OKC) | Run: 90 days | 8 mo |
| Ranalletta et al 2010 | V | WBAT | Brace unlocked to 90˚ | Immediate; 0-90˚ | Agility: 7 mo; Run: 5 mo | 9 mo | |
| Seon JK et al., 2006 | III | NWB × 7 wk; PWB × 4 wk; FWB by 12 wk | Extension brace × 4 wks, d/c brace at 12 wk | Run: 6 mo | |||
| Spiridonov et al 2011 | IV | NWB × 6 wk; FWB by 7 wk | Jack PCL brace × 6 mo† | Immediate; 0-90˚ | Run: 6 mo‡ | 9 mo | |
| Stannard & McKean 2009 | III | WBAT | Extension brace × 1 wk; unlocked | Immediate, no restriction | Run: 6 mo | 6 mo | |
| Taylor & Miller 2009 | V | WBAT | Extension brace | Begun in prone | Discouraged | Run: 4 mo | 6 mo |
| Tornese et al 2008 | II | Extension brace × 1 wk; unlocked, d/c brace at 6 wk | Immediate; 0-90˚ | Medium impact: 8 mo; High impact: 9 mo§ | |||
| Wong et al 2009 | II | PWB × 6 wk; FWB by 7 wk | Extension brace × 4 wk | 6 wk | 6-12 mo | ||
| Wu et al 2007 | IV | PWB × 6 wk; FWB by 7 wk | Extension brace × 1 wk | Immediate; 0-90˚ | 6 wk | 6 mo (light), 9 mo (full) | |
| Xu et al 2014 | III | LARS - PWB × 4 wk; FWB by 5 wk; HTG -NWB × 2 wk, PWB weeks × 7 wk; FWB by 10 wk | Protective brace × 8 wk | Delayed; LARS > 1 wk; HTG > 3 wk (0-90˚) | LARS: RTS: 2 mo (light), 4 mo (full); HTG: RTS: 4 mo (light), 10 mo (full) | ||
| Zayni et al 2011 | III | Extension brace × 45 days | 6 mo | Run: 150 days | 7 mo | ||
| Zhao & Huangfu, 2007 | IV | Extension brace × 2 mo | Delayed, > 3 wk (0-120˚) | Run: 3 mo | |||
| Zhao et al, 2008 | IV | Extension brace × 2 mo | Delayed, > 3 wk (0-120˚) | Run: 3 mo | 12 mo |
Abbreviations: wk, week(s); mo, month(s); NWB, Non-weight-bearing; PWB, TTWB, toe touch weight-bearing; partial weight-bearing (20-80% full weight-bearing); FWB, Full weight-bearing; LARS, Ligament Advanced Reinforcement System; HTG, Hamstring Tendon Autograft; d/c, discharge; ROM, range of motion; plyo, plyometrics; *, Level of evidence based on Oxford Centre for Evidence Based Medicine - Levels of Evidence; †, additional criteria prior to discharge of brace; ‡, additional criteria prior to running; §, additional criteria prior to return to sport