The effect of preoperative rehabilitation on the outcome of anterior cruciate ligament reconstruction

Abstract

Background and Objectives: Internal knee injuries account for nearly 45% of sports-related injuries, with anterior cruciate ligament (ACL) injury being the most prevalent. ACL injury is associated with pain, instability of the joint, muscle weakness, functional limitation, poor quality of life, and an increased risk of knee-related osteoarthritis. Preoperative exercise rehabilitation physiotherapy program is often performed to prepare the knee for reconstruction surgery and to maximize the outcomes of rehabilitation. The objective of our study was to evaluate the effects of preoperative rehabilitation on the outcome of ACL reconstruction (ACLR) using the International Knee Documentation Committee (IKDC) score, Tegner Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS), patients' symptoms, including tenderness, effusion, and range of motion limitations. Materials and Methods: Thirty patients with ACL injury were included in this study after obtaining informed consent and followed up till 12 months. A detailed history and evaluation were done. All patients who met the inclusion criteria were randomly allocated into two groups, one receiving a course of preoperative rehabilitation of 12 weeks, and one who were taken up for surgery without preoperative rehabilitation. Pre- and postsurgery, each of these groups was assessed at 3-, 6-, and 12-month intervals using the IKDC, KOOS, and Tegner Lysholm scores. Results: On analysis, it was found that the mean IKDC, KOOS, and Tegner Lysholm scores increased significantly for all patients from preoperative to postoperative 12 months. There was a statistically significant difference between the prehab and non-prehab groups, in each of these scores, with the prehab group having better functional scores. Conclusion: It was found that in individuals with ACL tear, arthroscopic ACLR improved the functional outcome, and among these patients, it was found that individuals who received preoperative rehabilitation fared better in terms of functional score assessment.