National Physical Therapy Examination (NPTE) Practice Exam

In a post-operative patient following ACL reconstruction, what is the primary deficit that physical therapy should address?

1. Lack of active knee extension

2. Lack of passive knee extension

3. Lack of passive knee flexion

4. Lack of active knee flexion

The correct answer is: Lack of passive knee extension

Following ACL reconstruction, the primary focus of physical therapy is on achieving full knee extension. Adequate knee extension is crucial for restoring normal gait mechanics and biomechanics of the knee, as well as ensuring that the joint can function properly during the rehabilitation process. The inability to achieve full passive knee extension can lead to long-term functional deficits, such as limited range of motion during activities and compensatory movements that could increase stress on the knee joint. While active knee extension is also important, particularly as the patient progresses in their rehabilitation, the initial phase post-surgery often sees more pronounced deficits in passive extension due to swelling, injury to surrounding structures, or muscle guarding. Therefore, addressing the passive lack of knee extension is essential to facilitate the re-establishment of a full and functional range of motion, which is necessary for the surgical site to heal appropriately and for the patient to regain strength and mobility. Other deficits, such as lack of passive knee flexion or lack of active knee flexion, do not usually pose the same immediate threat to functional recovery as the inability to achieve passive extension. Prioritizing the restoration of passive knee extension helps ensure a solid foundation for the subsequent phases of rehabilitation.