Rehabilitation programs have progressed alongside surgical advances in ante
rior cruciate ligament reconstruction. A perioperative program has been suc
cessfully used at our clinic for more than 10 years to reduce postoperative
complications and return patients to activity safely and quickly. The four
-phase program starts at the time of injury and preoperatively includes agg
ressive swelling reduction, hyperextension exercises, gait training, and me
ntal preparation. Goals after surgery are to control swelling while regaini
ng full knee range of motion. After quadriceps strengthening goals are reac
hed, patients can shift to sport-specific exercises.