Accelerated versus standard rehabilitation after anterior cruciate ligament reconstruction: A systematic review and meta-analysis of randomized controlled trials

Background and Aims: The objective of the study is to systematically compare the clinical outcomes of accelerated versus standard rehabilitation protocols following anterior cruciate ligament reconstruction (ACLR), with a specific focus on patient-reported outcome measures (PROMs) and knee laxity. Materials and Methods: We conducted a systematic review (SR) and meta-analysis by searching Medline (PubMed), Embase, and Web of Science for studies published up to January 14, 2026. We identified randomized controlled trials (RCTs) involving patients ≥16 years of age who underwent either standard or accelerated rehabilitation after ACLR. Studies were required to report on PROMs or knee laxity. Two reviewers independently screened, extracted, and appraised data using the Joanna Briggs Institute Checklist for RCTs. A random-effect meta-analysis was performed to calculate pooled mean differences (MDs). Preferred Reporting Items for SRs and Meta-analyses guidelines were followed for reporting this SR. Results: From a total of 894 records screened, 12 RCTs met the inclusion criteria. Accelerated rehabilitation protocols were characterized by early weight-bearing and immediate range of motion exercises. Regarding PROMs, the accelerated group showed small between-group differences favoring accelerated rehabilitation at some short- to mid-term follow-up time points, while several comparisons were not statistically significant and heterogeneity was substantial for certain outcomes. Conclusion: Regarding PROMs, the accelerated group showed small between-group differences favoring accelerated rehabilitation at some short- to mid-term follow-up time points, while several comparisons were not statistically significant and heterogeneity was substantial for certain outcomes.