Immediately after reconstruction of the anterior cruciate ligament, 110 patients were randomly assigned to treatment with high-intensity neuromuscular electrical stimulation (thirty-one patients), high-level volitional exercise (thirty-four patients), low-intensity neuromuscular electrical stimulation (twenty-five patients), or combined high and low-intensity neuromuscular electrical stimulation (twenty patients). All treatment was performed isometrically with the knee in 65 degrees of flexion. All of the patients participated in an intensive program of closed-kinetic-chain exercise. After four weeks of treatment, the strength of the quadriceps femoris muscle and the kinematics of the knee during stance phase were measured. Quadriceps strength averaged 70% or more of the strength on the uninvolved side in the two groups that were treated with high-intensity electrical stimulation (either alone or combined with low-intensity electrical stimulation), 57% in the group that was treated with high-level volitional exercise, and 51% in the group that was treated with low-intensity electrical stimulation. The kinematics of the knee joint were directly and significantly (p < 0.05) correlated with the strength of the quadriceps. There was a clinically and statistically significant (p < 0.05) difference in the recovery of the quadriceps and the gait parameters according to the type of operation that had been performed: the patients who had had reconstruction of the anterior cruciate ligament with use of an autologous patellar-ligament graft did poorly compared with the other patients.

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