109 Superior outcomes after progressive pre- and postoperative rehabilitation compared with usual care 10 years after anterior cruciate ligament reconstruction. (25th January 2023)

• Record Type: Journal Article
• Authors: Urhausen, Anouk; Pedersen, Marie; Grindem, Hege; Engebretsen, Lars; Snyder-Mackler, Lynn; Risberg, May Arna
• Is Part Of: BMJ open sport & exercise medicine. Volume 9(2023)Supplement 1
• Page Start: A13
• Page End: A14
• Publication Date: 2023-01-25
• Subjects: Sports medicine -- Periodicals; Exercise therapy -- Periodicals; 617.102705
• DOI: 10.1136/bmjsem-2023-sportskongres2023.37
• Languages: English
• ISSNs: 2055-7647

Abstract

Abstract : Introduction: Better two-year outcomes are achieved when anterior cruciate ligament reconstruction (ACLR) is combined with progressive preoperative and postoperative rehabilitation than with usual care, but long-term outcomes are not investigated. We therefore compared patient-reported outcomes 10 years after ACLR in patients who followed progressive preoperative and postoperative rehabilitation versus those who followed usual care. Materials and Methods: We included patients from the Norwegian arm of the Delaware-Oslo ACL cohort (progressive preoperative and postoperative rehabilitation, n=101) and the Norwegian Knee Ligament Registry (usual care, n=3162). Patients had primary unilateral ACLR using a patellar tendon or hamstring autograft after 2006, no substantial concomitant injuries, and were aged 13–40 years. The 10-year Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale scores and proportion exceeding the patient-acceptable symptom state (PASS) threshold were compared with one-way analysis of covariance (adjusted for sex, age, time to surgery, and cartilage/meniscus injury at ACLR) or chi-square tests (α=0.05). Results: Eighty-three (83%) and 1477 (53%) patients attended the 10-year follow-up. Patients who received progressive preoperative and postoperative rehabilitation had superior outcomes for KOOS pain, symptoms, activities of daily living, sports and recreation compared with usual care (p<.001), with the largest difference in sports and recreation (13±6 points). A greater proportion also exceeded the PASS-threshold compared to patients who received usual care (53–97% versus 38–83%, p≤.003). Conclusion: Ten years after ACLR, patients who received progressive preoperative and postoperative rehabilitation had better knee function and symptoms, and a greater proportion achieved acceptable symptoms compared to patients who underwent usual care.