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Chapter 120are facilitators for adherence to rehabilitation programmes after this procedure.32Because of the importance of proper rehabilitation after ACL reconstruction, improving compliance with rehabilitation will have a major effect on outcome. As the majority of patients that injure their ACL participate in pivoting sports, predominantly football, current rehabilitation protocols focus on return to pivoting sports.1 Before actual field training can commence, lots of hours have been spent at the gym to regain knee strength. This may be a reason why overall compliance is low. Patients may not be motivated to rehabilitate, as they ‘just want to play the game’ (i.e. return to sports). Challenging patients during rehabilitation and focusing on the output of the movement instead of the movement itself may trigger patients to be more compliant with the rehabilitation. This may not be the case for all patients after ACL reconstruction, but by providing more options for rehabilitation a more patient-specific rehabilitation can be achieved, stimulating intrinsic motivation. General aim of this thesis The general aim of this thesis is to optimise the biomechanical and functional outcome after ACL reconstruction. Therefore, the main focus lies on the effects of ACL reconstruction on knee kinematics, especially range of tibial rotation. The aim of the first part of the thesis is to study the effect of an ACL graft on range of tibial rotation and the link between this range of tibial rotation and subjective knee function and psychological readiness to return to sports in sports-related activities. An additional aim is to gain insight into the link between range of tibial rotation and the slope of the tibial plateau. The second part of the thesis focuses on individualising ACL reconstruction and rehabilitation. The aim of the second part of the thesis is to develop a patient-specific guide to ensure a femoral tunnel position in the native footprint of the ACL. Final aim is to determine the feasibility of an alternative rehabilitation protocol after ACL reconstruction.Mark Zee.indd 20 03-01-2024 08:56