The rehabilitation of two patients with functionally unstable ACL deficient knees: a case report

The general consensus is that ACL reconstruction should be undertaken if the patient has functional instability. Functional instability occurring is not just related to the mechanical insufficiency, but also to the neurophysiological role the ACL has in motion control. It may be, possible to enhance control of the abnormal joint motion through neuromuscular training. This case presentation outlines the rehabilitation of two patients with ACL deficient knees, who both presented with functional instability and discusses the role of conservative treatment in the management of this type of patient.The cases reported on indicate that with appropriate rehabilitation, some patients with functional symptomatic instability and a wish to return to high stress sports can be successfully rehabilitated to achieve these goals. The patients achieved these outcomes despite not having a change in joint laxity on passive testing. The significance of joint laxity tests on short term outcome would appear therefore to be not that great, with functional outcome after a period of rehabilitation proving a more sensitive indicator of the need for surgery in the ACL deficient patient.