A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Integumentary System

International Journal of Sports Physical Therapy, 2022 · DOI: https://doi.org/10.26603/001c.29454 · Published: January 1, 2022

Orthopedics Rehabilitation Dermatology

Simple Explanation

After ACL reconstruction, rehabilitation traditionally targets musculoskeletal components, but the integumentary system (skin) is also important. Skin issues can signal healing problems and prolong recovery. Evaluating incision appearance, nerve function, and overall health helps determine recovery goals. Skin care minimizes strain, promotes healing, and allows for interventions like strength training. Integrating the integumentary, cardiovascular, neurological, and muscular systems is crucial for returning to activity. This approach provides a better understanding of the integumentary system's role.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Key Findings

1
The integumentary system contributes to thermoregulation, sensation, and fascial mobility, all crucial for rehabilitation after ACLR.
2
Proper wound care, including cleaning, emollients, and dressings, is essential in the first 12 days post-operatively to prevent wound dehiscence and promote efficient healing.
3
Sensory loss around the knee after ACLR can lead to other sensory impairments, such as burns or altered proprioception, requiring targeted rehabilitation interventions.

Research Summary

The integumentary system (IS) is often overlooked in ACLR rehabilitation, but impairments can limit movement. The IS contributes to temperature regulation, sensation and mobility. Assessment of the IS should include the patient's history, surgical history, and observation of the skin for incision closure, integrity, discoloration, edema, scarring, nodules, and/or scaly skin. Proper care of the IS can decrease the risk of infection that could delay or severely dismantle the progress of an individual’s ACL rehabilitation.

Practical Implications

Optimized Rehabilitation Protocols

Integrating integumentary system management into ACLR rehabilitation protocols can improve patient outcomes.

Enhanced Patient Education

Educating patients on proper skin care and the importance of monitoring incision sites can prevent complications and promote healing.

Interdisciplinary Collaboration

Collaboration between physical therapists, surgeons, and dermatologists can address complex scarring and sensory issues.

Study Limitations

1
Lack of specific guidelines for integumentary system assessment and treatment after ACLR.
2
Limited research on the long-term impact of integumentary interventions on functional outcomes.
3
Variability in surgical techniques and graft types may influence integumentary system healing.

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