Acupuncture as an Adjunct to Rehabilitation After Anterior Cruciate Ligament Injury and Reconstruction: An Anatomical and Neurophysiological Narrative Review.
- 1Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, GRC.
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.
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BibTeX
@article{kagkarakis2026acupuncture,
title = {{Acupuncture as an Adjunct to Rehabilitation After Anterior Cruciate Ligament Injury and Reconstruction: An Anatomical and Neurophysiological Narrative Review.}},
author = {Dimitrios Kagkarakis and Alexandros Samolis and Dimosthenis Chrysikos and George Triantafyllou and George Tsakotos and Maria Piagkou},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117053},
url = {https://europepmc.org/article/MED/42953464},
note = {CC BY},
}
RIS
TY - JOUR
TI - Acupuncture as an Adjunct to Rehabilitation After Anterior Cruciate Ligament Injury and Reconstruction: An Anatomical and Neurophysiological Narrative Review.
AU - Dimitrios Kagkarakis
AU - Alexandros Samolis
AU - Dimosthenis Chrysikos
AU - George Triantafyllou
AU - George Tsakotos
AU - Maria Piagkou
PY - 2026
DA - 2026/09/28
JO - Cureus
DO - 10.7759/cureus.117053
UR - https://europepmc.org/article/MED/42953464
AB - 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.
SN - 2168-8184
ER -