Acupuncture as an Adjunct to Rehabilitation After Anterior Cruciate Ligament Injury and Reconstruction: An Anatomical and Neurophysiological Narrative Review
Year: 2026
Type: review
Abstract: Pain, effusion, quadriceps inhibition, and impaired proprioception are common challenges during recovery from anterior cruciate ligament (ACL) injury and reconstruction. While acupuncture is employed in certain rehabilitation protocols, evidence specific to ACL injury and ACL reconstruction (ACLR) remains limited and is frequently discussed alongside studies of chronic knee disorders. This narrative review investigates the surgical and neuroanatomical foundations of acupuncture around the knee, summarizes proposed neurophysiological mechanisms, and reviews the clinical literature most directly pertinent to ACL injury and ACLR. We conducted a comprehensive PubMed/MEDLINE search for studies involving acupuncture or electroacupuncture in conjunction with ACL injury or ACLR, supplemented by searches on knee sensory innervation, acupoint neuroanatomy, acupuncture safety, and higher-level evidence on knee pain. We also examined reference lists and cited articles. The extant literature on ACL/ACLR includes few small randomized or controlled trials, feasibility studies, a case report, and interventions using combined approaches. Some investigations report short-term improvements in pain, swelling, range of motion, or specific functional parameters; however, heterogeneity within the evidence base constrains definitive conclusions. Commonly utilized acupoints around the knee and leg are located proximate to periarticular tissues, muscle afferents, and identifiable peripheral nerves, rendering needle depth, direction, and regional anatomy clinically significant. Acupuncture may serve as an adjunctive modality for symptom management during ACL rehabilitation; however, current evidence does not support claims that it facilitates ligament repair, enhances graft incorporation, restores mechanical stability, prevents reinjury, or reduces the time required for a safe return to sport.
Source: Cureus
Institution: National and Kapodistrian University of Athens
Language: English
Subfield: Complementary and alternative medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7214600262