Knee injury recovery: when is the best time for surgery and rehab?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

For the clinical trials for both aims, male and female military personnel and civilians between the ages of 16 and 55 with a MLKI (defined as a complete grade III injury of two or more ligaments) will be eligible to participate. Individuals with a nerve injury or biceps or popliteus tendon rupture or avulsion will not be excluded from participation in either trial. Individuals will be excluded from both trials if they: 1. Prior knee ligament surgery of the involved knee; 2. Torn or avulsed patellar or quadriceps tendon; 3. Periarticular or long bone fracture that is anticipated to preclude weight-bearing after surgery; 4. Require use of an external fixator for greater than 10 days; 5. Planned staged surgical treatment; 6. Unable to weight bear on the contralateral uninjured leg; 7. Traumatic brain injury (TBI) that limits their ability to participate in their post-operative care; 8. Surgical procedures that precludes early weight-bearing or range of motion. 9. Any condition that would preclude the ability to comply with post-operative guidelines. Additional Eligibility Criteria for Participation in Aim 1 - Randomization to Both Timing of Surgery and Post-Operative Rehabilitation To be eligible to participate in the study for Aim 1 individuals with a MLKI must present to orthopaedic surgery in time to undergo definitive surgery within 6 weeks of injury if randomized to the early surgery group. Individuals will also be ineligible to participate in the study for Aim 1 if they have: 1. Vascular injury that dictates timing of surgery; 2. Poly trauma that precludes surgery within 6 weeks of injury; 3. Skin or soft tissue injury that precludes early surgery and rehabilitation. Additional Eligibility Criteria for Participation in Aim 2 - Randomization to Only timing of Post-operative Rehabilitation Subjects with a MLKI that present to orthopaedic surgery at a time that precludes randomization to early surgery or have an injury that precludes randomizing the timing of surgery (such as a vascular injury) as well as those that refuse randomization to the timing of surgery will be eligible to participate in the study for Aim 2 which randomizes subjects to only early vs. delayed rehabilitation. Individuals will also be excluded from the trial that randomizes only the timing post-operative rehabilitation if they have: 1. Vascular surgery that precludes early rehabilitation; 2. Polytrauma that limits ability to participate in post-operative care; 3. Skin or soft tissue injury that precludes early rehabilitation