PURPOSE: Anterior cruciate ligament (ACL) rupture is a common injury in athletes and active patients. Aquatic therapy seems to be effective for the rehabilitation after ACL reconstruction, good outcomes and shorter rehabilitation time have been reported compared to dry land rehabilitation. The purpose of this study is to compare the results of dry land and aquatic rehabilitation. The hypothesis is that aquatic rehabilitation is effective and could reduce the rehabilitation time after ACL reconstruction. METHODS: After ACL reconstruction, 24 patients were randomly divided into 2 groups, group A who received standard dry land physiotherapy, and group B who received an aquatic rehabilitation protocol. Both groups received 12 rehabilitation sessions. The outcomes of the two groups have been evaluated according to the improvement of their knee ROM, the International Knee Documentation Kommittee (IKDC), the Lysholm scales, and the Visual Analogue Scale (VAS) score. We designed a prospective randomized controlled trial (RCT). RESULTS: The knee flexion improved in both groups during the rehabilitation period. The functional scores, according to IKDC and Lysholm scale, improved in both groups at the final follow up. The mean score significantly improved at all time point, respectively 17.9 at T0, 33.2 at T1 and 40 at T2 (SD 2.07) for group A, and 20.5 at T0, 36 at T1, 41.8 at T2 (SD 2.06) for group B. The mean VAS score improved from 6.6 at T0 to 3.9 at final followup in group A, and form 5.9 at T0, to 3 at T2. When comparing the results of the two groups, no statistically significant differences have been reported. CONCLUSION: Both dry land and aquatic therapy are effective for the rehabilitation of patients after ACL reconstruction, but there is not one therapy superior to the other.

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