Controversy surrounding the use of open kinetic chain (OKC) exercises following anterior cruciate ligament (ACL) reconstruction, especially in the early phases has evolved over many decades.

It is known that the ACL graft is at its most vulnerable during the first 6-12 weeks following surgery, and it has been theorised that OKC exercises lead to increased laxity in the graft, thus placing it at greater risk of of failure. 

The current systematic review however, concludes that based upon the current available evidence, there does not appear to be any significant difference in graft laxity, quadriceps strength, patient-report function or physical function.