Anterior Cruciate Ligament Rehabilitation Research Articles

From Fear to Resilience: A Scoping Review of Psychological Components in Anterior Cruciate Ligament Rehabilitation.

Anterior cruciate ligament (ACL) injuries, prevalent in athletic contexts have profound physical and psychological impacts. Despite extensive research on the physiological aspects of ACL recovery, the psychological dimensions of this process have gained increased attention. This scoping review delves into the intricate landscape of psychological factors influencing ACL rehabilitation. Scoping review. A literature search across multiple databases was conducted to identify relevant published studies that provide insight into the psychological aspects of ACL recovery. This search spanned various study designs, enabling a nuanced understanding of the psychological intricacies surrounding ACL recovery. Overall, a total of 1830 unique articles were screened, of which 66 were included in this review. Our findings are further contextualized through alignment with insights from prior reviews on similar themes. Through a comprehensive analysis of diverse literature, we explore 3 key themes: psychological challenges, current rehabilitation programs, and the integration of psychological support. Psychological challenges emerged as a pervasive aspect of ACL rehabilitation, encompassing fear, anxiety, motivation, and depression. The nuanced emotional responses, particularly the fear of reinjury, impact treatment adherence and overall well-being. Contemporary rehabilitation programs revealed inconsistencies in incorporating psychological support, emphasizing the need for standardized, multidisciplinary approaches. The alignment with prior reviews in the literature reinforced the importance of psychological traits, such as knee self-efficacy, in predicting positive outcomes. This scoping review provides a comprehensive overview of psychological factors within ACL rehabilitation, highlighting the importance of tailored interventions and standardized approaches. The integration of multidisciplinary expertise emerges as crucial for optimizing patient outcomes. Our findings not only contribute to a nuanced understanding of psychological nuances in ACL rehabilitation but also offer valuable implications for clinical practice and policy development.

Patients follow four clusters of participation in physical exercise after an ACL injury. Results from the NACOX cohort study

ObjectivesTo explore how participation in physical exercise (PE) changes over time after an anterior cruciate ligament (ACL) injury. Additionally, to identify factors associated with participation in PE by analyzing longitudinal data. DesignAn explorative analysis of the NACOX study, a prospective multicenter cohort study. MethodsPatients with an acute ACL injury aged 15-40 years were followed for three years. The patients regularly reported participation in PE, knee function, new injuries, and surgeries. State sequence analysis and Hierarchical Cluster Analysis were used to analyze participation in PE. Clusters were compared using an analysis of variances, the Chi-square test, and Fischer’s exact test. ResultsThe study included 275 patients, 52% female, with a mean age of 25 years. Four clusters were identified, varying from low to high participation in PE after an ACL injury. Clusters differed regarding the number of ACL reconstructions (ACLR) (p = 0.03); time from injury to ACLR (p = 0.03); patient-reported knee function at the follow-ups at 3-months (p = 0.02), 6-months (p = 0.02), and 12-months (p = 0.02) after injury; PE level before injury (p < 0.001); and number of new injuries and surgeries (other than ACLR) (p = 0.001). ConclusionFour clusters, varying from low to high participation in PE after an ACL injury were identified. The results provide valuable insight into factors associated with different levels of participation in PE, which can be helpful for healthcare personnel working with ACL rehabilitation.

Review perspective on advanced nutrachemicals and anterior cruciate ligament rehabilitation.

Anterior cruciate ligament (ACL) injuries are prevalent among athletes, necessitating surgical intervention followed by comprehensive rehabilitation. Recently, the integration of nutraceuticals- bioactive compounds from food sources- into rehabilitation protocols has shown promise in enhancing recovery outcomes. This review explores the potential benefits of various nutraceuticals, including omega-3 fatty acids, collagen supplements, vitamin D, glucosamine and chondroitin, curcumin, and branched-chain amino acids (BCAAs), in ACL rehabilitation. These nutraceuticals offer anti-inflammatory properties, support tissue repair, and improve joint and muscle health, which are critical during the rehabilitation process. Despite encouraging preclinical findings, there is a need for robust clinical trials to confirm their efficacy and establish optimal dosages and formulations. Personalized nutrition plans and interdisciplinary collaboration among healthcare providers are essential for optimizing patient care. This perspective underscores the potential of advanced nutraceuticals to revolutionize ACL rehabilitation, paving the way for faster and more effective recovery pathways.

Blood Flow Restriction Training and Its Use in Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis

Background/Objectives: Anterior cruciate ligament (ACL) reconstruction (ACLR) is often followed by significant muscle atrophy and subsequent loss of strength. Blood flow restriction training (BFRT) has recently emerged as a potential mode of rehabilitation to mitigate these effects. The goal of this systematic review was to evaluate the efficacy of BFRT in functional recovery when compared to traditional rehabilitation methods. Methods: A literature review was conducted across July and August 2024 using multiple databases that reported randomised controlled trials comparing BFRT to traditional rehabilitation methods. Primary outcomes were changes to thigh muscle mass and knee extensor/flexor strength with secondary outcomes consisting of patient-reported functional measures (IKDC and Lysholm scores). The RoB-2 tool was used to assess the risk of bias. Results: Eight studies met the inclusion criteria; however, substantial heterogeneity prevented a meta-analysis being conducted for the primary outcomes. Three out of the five studies measuring muscle mass reported significant (p &lt; 0.05) findings favouring BFRT. There was variation amongst the strength improvements, but BFRT was generally favoured over the control. Meta analysis of the secondary outcomes showed significant improvements (p &lt; 0.05) favouring BFRT despite moderate heterogeneity. Conclusions: BFRT shows promise for maintaining muscle mass and improving patient reported outcomes following ACL reconstruction. However, the high risk of bias limits the strength of these conclusions. Further high-quality research needs to be conducted to establish optimal BFRT protocols for this cohort and to determine if BFRT has a place in ACL rehabilitation.

Changes in Y-Balance Test Scores During Months 4, 5, and 6 of ACL Reconstruction Rehabilitation.

The anterior cruciate ligament (ACL) is well researched since injuries typically result in lengthy recoveries and rehabilitation periods until athletes can return to full activity. Although a large body of literature on the early and late stages of rehabilitation following ACL reconstructive (ACLR) surgery exists, less is known regarding the mid-phase of ACL rehabilitation and healthy versus injured limb differences in functional testing during this stage. The purpose of this study is to determine if Y-Balance Test (YBT) scores obtained during the mid-phase of ACLR rehabilitation change over months 4, 5, and 6. Case Series. Research laboratory. Patients or Other Participants: A total of 27 participants (17 females; 18.96±3.02 years (range 15-24); 173.63±10.29cm; 72.55±17.83kg) who sustained a unilateral ACL injury, experienced no episodes of instability or knee giving away, had not suffered a previous ACL injury, and expressed a desire to return to sport at the end of rehabilitation came in once a month following ACLR to participate in a battery of tests. YBT scores in the anterior, posterolateral (PL), and posteromedial (PM) directions in the healthy and reconstructed limbs. A main effect for limb was observed for the anterior (Healthy: m4: 78.8cm±5.8, m5: 79.5cm±5.2, m6: 79.4±5.8; Reconstructed: m4: 77.2±5.9, m5: 78.5±5.1, m6: 78.1±6.4, p=0.023) and PM (Healthy: m4: 80.0cm±8.7, m5: 81.0cm±9.1, m6: 82.9cm±8.9; Reconstructed: m4: 79.3cm±6.8, m5: 79.4cm±8.2, m6: 81.1cm±8.5, p=0.013). directions indicating that the reconstructed limb performed worse than the healthy limb. A main effect for time was observed for the PL direction (Healthy: m4: 78.8cm±5.8, m5: 79.5cm±5.2, m6: 79.4cm±5.8; Reconstructed: m4: 77.2cm±5.9, m5:78.5cm±5.1, m6: 78.1cm±6.4, p=0.023). The YBT measured improvement in the PL direction across time in the reconstructed limb. In the PM and anterior directions, the YBT did not measure these same improvements across this period.

A Review on Rehabilitation and Return to Sport Criteria Post ACL Reconstruction in Athletes

Background: Anterior Cruciate Ligament (ACL) injuries are most often found in young active athletes. They range from mild (small tears or sprain) to severe (complete tear of ligament) and are mostly seen in sports like football, basketball, cricket, gymnastics, skiing, etc ACL reconstruction is a surgical knee procedure that requires intensive postoperative rehabilitation by the athlete to be able to return to sport. Methods: A systematic review was conducted considering the data sources PubMed (MEDLINE), Cochrane Library, PEDro, Google Scholar, EBSCO, Medscape, and Scopus databases using the keywords ACL reconstruction, rehabilitation, and return to sport criteria. The time frame ranged between 2017-2022 Results: The study selection process is presented according to PRISMA guidelines. After title and abstract screening, 50 full-text articles were assessed for eligibility 20 were excluded; the remaining 30 articles were deemed to meet the inclusion criteria and were included. The total number of RCTs included was thirty Conclusion: The thirty included RCTs offer convincing results on post-operative outcomes of muscular strength, function, patient reported symptoms and determination of return to sport criteria. There is limitation in holistic evidence that looks into the psychological as well as physical components of rehabilitation of an athlete that will also accelerate the return to sport duration. Keywords: ACL reconstruction, rehabilitation, return to sport criteria

Effect of open vs. closed kinetic chain exercises in ACL rehabilitation on knee joint pain, laxity, extensor muscles strength, and function: a systematic review with meta-analysis.

PROSPERO [CRD42023475230].

Effects of Supervised Plyometric Training on Neuromuscular and Knee Functions for Late Phase Rehabilitation Program in Patients with Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Objective: To determine the effects of plyometric training programs on neuromuscular and knee functions during the late phase rehabilitation following anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Thirty participants, post-ACL reconstruction, were randomly assigned at their 6-month follow-up visit into two groups: 15 participants in each group (resistance or plyometric training group). Each group underwent two training sessions weekly for 8 weeks. The participants were assessed at baseline and after completed the training period for the single leg 6-meter timed hop, knee joint position sense, static and dynamic balance, isokinetic muscle strength and the International Knee Documentation Committee Subjective Knee Form. Results: Post an 8-week training period, both groups showed improvements in the single leg 6-meter timed hop. Notably, the limb symmetry index for this hop in the plyometric group was significantly higher than the resistance group {18.2% (10.2, 26.1) vs 6.2% (-2.0, 14.5) respectively}. The plyometric group also demonstrated significantly better knee joint position sense {-3.1° (-4.3, -1.9) vs -0.8° (-2.0, 0.4) respectively}and the unipedal stance on a stable surface with eyes closed {13.9 sec (2.7, 25.2) vs -2.6 sec (-14.3, 9.1) respectively} than the resistance group. Conclusion: Plyometric training in the late phase of ACL rehabilitation program has proven to be a suitable and effective approach for enhancing neuromuscular and knee functions.

Cost-Outcome Descriptive Study for Mobile App (UPSCALER) in the Rehabilitation of Anterior Cruciate Ligament (ACL) Injuries After Reconstructive Surgery

Cost-Outcome Descriptive Study for Mobile App (UPSCALER) in the Rehabilitation of Anterior Cruciate Ligament (ACL) Injuries After Reconstructive Surgery

Comparison of Blood Flow Restriction Interventions to Standard Rehabilitation After an Anterior Cruciate Ligament Injury: A Systematic Review.

Blood flow restriction training (BFR-t) data are heterogeneous. It is unclear whether rehabilitation with BFR-t after an anterior cruciate ligament (ACL) injury is more effective in improving muscle strength and muscle size than standard rehabilitation. To review outcomes after an ACL injury and subsequent reconstruction in studies comparing rehabilitation with and without BFR-t. Systematic review. Level of evidence, 3. A search of English-language human clinical studies published in the past 20 years (2002-2022) was carried out in 5 health sciences databases, involving participants aged 18-65 undergoing rehabilitation for an ACL injury. Outcomes associated with muscle strength, muscle size, and knee-specific patient-reported outcome measures (PROMs) were extracted from studies meeting inclusion criteria and compared. The literature search identified 279 studies, of which 5 met the selection criteria. Two studies suggested that BFR-t rehabilitation after an ACL injury improved knee or thigh muscle strength and muscle size compared with rehabilitation consisting of comparable and higher load resistance training, with two studies suggesting the opposite. The single study measuring PROMs showed improvement compared to traditional rehabilitation, with no difference in muscle strength or size. BFR-t after an ACL injury seems to benefit muscle strength, muscle size, and PROM scores compared with standard rehabilitation alone. However, only 1 large study included all these outcomes, which has yet to be replicated in other settings. Further studies utilizing similar methods with a common set of outcome measures are required to confirm the effects of BFR-t on ACL rehabilitation.

Is it time to develop specific return to running criteria for ACL rehabilitation? An international survey of physiotherapists criteria for return to running following ACL injury

ObjectiveTo determine return to running criteria currently used by physiotherapists following anterior cruciate ligament (ACL) injury. DesignSelf-reported online international survey. MethodsAn online survey of physiotherapists across Australia, the Netherlands and France. ResultsA total of 476 respondants participated in the survey across Australia (n = 153), the Netherlands (n = 162), and France (n = 161). For return to running criteria following a non-operative approach, the majority of respondents chose swelling (40.55%, n = 193/476), pain (38.24%, n = 182/476), knee extensor strength (34.34%, n = 163/476), single leg squat (31.93%, n = 152/476) and knee flexor strength (29.83%, n = 142/476). After ACL reconstruction, the highest responses were also swelling (41.18%, n = 196/476), pain (37.18%, n = 177/476), knee extensor strength (37.18%, n = 177/476) and single leg squat (33.19%, n = 158/476). From the identified themes the most common cutoff variables were pain between 0 and 3/10, swelling < grade 1+ and limb symmetry on strength and hop tests >70 %. ConclusionPhysiotherapists in Australia, France, and the Netherlands use many different return to running criteria and most of them use more than one criterion. Despite this, there was little consensus on the cut-off physiotherapists use to apply these criteria.

Effectiveness of Blood Flow Restriction Training on Increasing Strength in Post Surgery Rehabilitation of Anterior Cruciate Ligament (ACL) Compared with Traditional ACL Rehabilitation Protocol

Background: Patients who have anterior cruciate ligament restoration surgery endure a severe loss of strength intheir lower limbs as a result of muscle atrophy and arthrogenic inhibition. A relatively novel method for eitherpreventing muscle atrophy or maybe inducing muscular growth is blood flow restriction (BFR) training.Purpose: The Purpose of the study is to determine effectiveness of blood flow restriction training in post-surgeryrehabilitation of anterior cruciate ligament compared with traditional ACL rehabilitation protocol.Materials and Methods: Total of 50 samples was selected based on inclusion and exclusion criteria. The subjectswere separated as Group A and Group B where group A (n=25) is provided with blood flow restriction trainingand group B (n=25) is provided with strengthening exercise. Results were statistically analysed and tabulated.Result: The study found that there is significant improvement on anterior cruciate ligament surgery in post rehabusing NPRS and Range of motion. The results concluded that the improvement in blood flow restriction trainingwas extremely statistically significant.Conclusion: Blood flow restriction training was found to be more effective than strengthening exercise for thetreatment of post rehabilitation of anterior cruciate ligament surgery.

Differences in athletic identity, sport participation, and psychosocial factors following anterior cruciate ligament rehabilitation in youth athletes.

While youth sports benefits the developing athlete, athletes may also be subject to injury and subsequent return-to-sport protocols. The current return-to-sport criteria emphasize physical measures; however, psychological measures may also be valuable to inform providers of an athlete's readiness. One such measure is athletic identity defined as the degree to which an individual identifies with the athlete role. To better understand athletic identity in return-to-sport, this study aimed to identify relationships and trends between the Athletic Identity Measurement Scale (AIMS), demographic variables, sport participation measures, and the Athletic Coping Skills Inventory-28 (ACSI-28) in youth athletes during rehabilitation following anterior cruciate ligament reconstruction (ACLR). A retrospective review was completed of patients who underwent ACLR at a sports medicine clinic between October 2019 and May 2021. Patients responded to a series of patient reported outcomes (PROs) regarding physical and psychological function at a pre-surgical baseline and after 1 year of rehabilitation. Patients were then divided into groups of high/low AIMS and an increased/decreased AIMS between 1 year and baseline for comparison. Independent samples t-tests and ANOVAs were performed as appropriate with a 95% confidence interval. In the final sample, 87 patients (15.3 ± 1.8 years) were included, with 51.7% being females. Total AIMS scores decreased from 50.3 to 47.5 over rehabilitation (p = 0.019). Furthermore, results indicated that nearly all AIMS scores decreased during rehabilitation, with none showing an increase; however, not all domains were significant. Conversely, all sport participation and coping ability PROs increased over time points except for ACSI-Confidence and Achievement Motivation. Generally, those in the groups with high AIMS and an increase in AIMS also had higher scores in physical function and coping ability PROs, with the groups separated by high/low AIMS exhibiting more frequent statistical significance. Given these results, it appears that athletes may lose identification with the athlete role after ACLR and struggle even 1 year for rehabilitation, but those who recover athletic identity the best may also be those able to cope most effectively with the stressors induced by injury.

Ab. No. 121 Digital Therapy During Anterior Cruciate Ligament (ACL) Rehabilitation Through Evidence-Based Feedback Using Wearable Device Pheezee®, A Case Study

Introduction: The outcome following Anterior Cruciate Ligament (ACL) repair depends largely on post-surgical rehabilitation protocol. Recovery map is generally quantified using ROM of knee, outcome score, and seldom muscle activity is considered. The aim is to bring about objective outcome measures during ACL rehabilitation programs where evidence-based feedback assists clinicians to develop dynamic treatment protocols and encourages remote personalized patient care. This study advocates physiotherapists to integrate ROM, sEMG in ACL rehabilitation, establishing a comprehensive technologically advanced approach. Methods: This study includes a single participant who experienced ACL injury, underwent reconstruction surgery followed by post rehabilitation regime, and was remotely monitored using the wearable device. In this case study, ROM and sEMG data were acquired using a novel app-based wearable device Pheezee®. The study employed quantitative analysis of prehab to post-surgical rehabilitation for one year. The objective data was interpreted and compared from the pre-operative to post-operative stages. Results: A satisfactory flexion of 139º and extension of 4º was achieved during post-op, which was comparable to the pre-op range. This is also reflected in the weekly muscle strength trend, where the quadriceps muscles have drastically improved (especially Vastus Lateralis), responsible for knee extension. Conclusion: Knee joint movement is improved from pre- to post-surgical states by adhering to Pheezee® based weekly assessments and exercise protocols. We observed that the acquired data is beneficial for both the physiotherapist and the participant in achieving their goals and making informed clinical decisions leading to modifications in the exercise protocols, use of brace, and walking aids. Further studies are required to determine correlation of subjective perceptions with objective outcomes. Implications: Real-time data helps in making informed clinical decisions, and tailor-made interventions insisting on an evidence-based approach and technology-enabled rehabilitation for effective, comprehensive, and personalized patient care.

Effect of Virtual Reality and Augmented Reality Training for Injury Prevention and Accelerating Rehabilitation of Anterior Cruciate Ligament Injury in Athletes: A Scoping Review

Context: Recently, the use of Virtual reality (VR) and Augmented reality (AR) tools for assessing athletes’ performance in returning to sports and neuromuscular training has experienced significant growth across all age groups. Through this technology, by utilizing laboratory facilities and creating a three-dimensional simulated sports environment that closely resembles the reality and conditions of each sports discipline, athletes can train and undergo evaluation under controlled conditions. The VR and AR systems have been used recently to prevent and rehabilitate Anterior Cruciate Ligament (ACL) injuries and assess the motor control of injured individuals. This scoping review aimed to investigate the impact of VR and AR exercises on ACL injury prevention, ACL rehabilitation, and expediting the return to sports process. Evidence Acquisition: The scoping review follows the reporting system of systematic and meta-analysis studies (PRISMA-ScR) and utilizes the guidelines provided by the Joanna Briggs Institute for conducting various stages of work and data extraction. This study was registered in the PROSPERO database with code CRD42023446354. The search for English articles was conducted in electronic databases, including PubMed, Embase, Web of Science, SPORT Discuss, PsycINFO, CINAHL, and Cochrane, using keywords such as virtual reality, rehabilitation, injury prevention, simulation, augmented reality, ACL, and anterior cruciate ligament until the end of June 2022. Inclusion criteria encompassed any primary research involving both athletes and non-athletes across all levels (from beginners to professional) and all ages and genders (male and female) who have experienced unilateral anterior cruciate ligament injury and have undergone any type and degree of sports or therapeutic intervention using VR and AR systems. Results: Twenty-six out of 204 comprehensive studies were reviewed based on the inclusion and exclusion criteria. The results showed that biomechanical parameters related to ACL injury were measured using various methods such as real-time biofeedback, virtual reality, and augmented reality. The factors investigated showed significant changes after exercise in VR and AR environments. Conclusions: Anterior cruciate ligament injury (or any other sports injury) cannot be summarized in a single musculoskeletal dimension involving mechanical or movement dysfunction. The failure of current approaches to prevent ACL injuries, rehabilitation, and risk assessment is due to the neglect of cognitive and neurological aspects of the injury. New methods such as augmented neuromuscular training (aNMT), multidimensional rehabilitation approaches, and the utilization of virtual reality technology and novel training strategies based on the strengths of VR and AR systems (such as optimal strategy) can compensate for this scientific and practical gap.

Progressive submaximal effort hamstring muscle endurance is reduced after reconstruction of the anterior cruciate ligament

BackgroundEndurance capability in the muscles controlling the knee is poorly understood post anterior cruciate ligament (ACL) reconstruction, despite many sporting activities requiring notable muscle endurance. The hamstring muscles, when active, provide important anatomical support to protect the reconstructed graft. In the absence of good hamstring endurance, fatigue may predispose individuals to re-injury. ObjectiveTo assess whether ACL reconstruction (ACLR) with a hamstring graft leads to reduced hamstring endurance 9–13 months post-surgery. Study designA cross-sectional inter-limb comparison study was undertaken with participants 9–13 months after an ACLR with a hamstring graft, and a group of age, sex, and activity-matched controls. There were 22 participants in each group. MethodSubmaximal hamstring endurance was measured using a progressive fatigue test on an isokinetic dynamometer at a joint angular velocity of 120°/second. The dependant variable was the maximum number of repetitions performed. Statistical comparisons were made across injured, uninjured and control group limbs. ResultsThere was a significant (p < 0.05) deficit in hamstring endurance observed between the injured leg (mean: 111 repetitions, SD 49) and uninjured leg (mean: 136 repetitions, SD 67) of the ACL group, but not between the uninjured and control group legs (mean: 124 repetitions, SD 50). ConclusionThe 18% deficit in submaximal hamstring endurance across the ACL-reconstructed individual's limbs is indicative of a notable loss in muscle performance at 9–13 months post-surgery. These results provide initial evidence for supporting further research examining the inclusion of hamstring endurance training in ACL rehabilitation programmes post-surgery.

The Interval Kicking Program (IKP) as a Reprogramming Technique for the Soccer Player in an Anterior Cruciate Ligament (ACL) Rehabilitation: A Technical Report

The Interval Kicking Program (IKP) as a Reprogramming Technique for the Soccer Player in an Anterior Cruciate Ligament (ACL) Rehabilitation: A Technical Report

Analyzing the Quality, Reliability, and Educational Value of ACL Rehabilitation Exercises on TikTok: A Cross-Sectional Study.

Videos relating to rehabilitation exercises for common injuries relevant to younger populations such as anterior cruciate ligament (ACL) tear receive high view counts on social media platforms such as TikTok. The purpose of this study was to analyze the quality, reliability, and educational value of TikTok videos among the patient population for ACL injury. It was hypothesized that TikTok videos related to ACL rehabilitation exercises would lack quality, reliability, and educational value. Cross-sectional study. TikTok was queried for relevant videos using the hashtags "#ACLrehab" and "#ACLexercises." For each included video, the type of uploader (general user or health care professional) was identified. In addition, the number of views, likes, shares, comments, and favorites for each included video was recorded, and the content of each video was graded using the DISCERN (a well-validated informational analysis tool) and the ACL exercise education score (ACLEES - a custom-designed tool for the evaluation of ACL-related exercises). A total of 111 videos with 5,520,660 cumulative views were included; the median number of views per video was 9801.0 (interquartile range [IQR], 3583.0-28,000.0). Of these videos, 84 and 27 were created by the general public and health care professionals, respectively. The videos collectively received 335,577 likes, 2969 comments, 22,856 favorites, and 6142 shares, with a median of 439 (IQR, 111-1374), 10 (IQR, 2.5-25.5), 54 (IQR, 18-172.5), and 12 (IQR, 2-36), respectively. The tabulated scores for the DISCERN and ACLEES between general users and health care professionals were all statistically nonsignificant. Health care professionals had a higher percentage of videos with a "very poor" DISCERN score in comparison with the general public (66.67% vs 53.57%, respectively). The overall educational value of the TikTok videos related to ACL rehabilitation exercises was very poor. Health care professionals should be aware of the broad distribution of ACL rehabilitation exercise videos that are accessible on TikTok and raise awareness of the deficiencies of the platform as a medium for educational medical-related information.

A Comparative Study of Anterior Cruciate Ligament Reconstruction Versus Conservative Treatment.

Background The anterior cruciate ligament (ACL) rupture is a common injury with an incidence of 68.6 in 100,000 patients per year. Despite extensive research on ACL rupture, there are insufficient high-quality studies to determine clear treatment strategies for adults lacking the ACL. This study aims to examine the functional differences between surgical and conservative treatment based on the quality of the surgical process. Methodology In this prospective, comparative study, a total of 136 patients aged between 18 and 35 years were enrolled per inclusion and exclusion criteria. Using the lottery system, patients were dividedinto the following two groups: group A (n = 71) and group B (n = 65). Group A was treated with arthroscopic ACL reconstruction and rehabilitation, whereas group B was treated conservatively (rehabilitation). Patient data, including age, sex, body mass index, International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Level (TAL) score, and complications were recorded and compared. Results The demographic data were comparable, where males had dominancy in both groups. The mean IKDC and KOOS scores were higher in group A at all follow-ups compared to group B. The scores gradually increased at every follow-up till six months. At the final follow-up, the IKDC and KOOS scores were higher in group A than in group B, and a significant difference was observed among both groups. The TAL score also gradually increased at every follow-up till 6 months. At the final follow-up, the TAL score was higher in group A than in group B, with a significant difference between the two groups (p = 0.0032). Complications in both groups were comparable. Conclusions This study showed that both the conservatively treated group and the rebuilt group had identical outcomes, with the exception of the conservative group having greater objectively quantifiable instability. However, at the final follow-up, patients reported feeling just as satisfied with their knee without surgery, demonstrating no subjective difference in activity levels or functional outcomes. Therefore, non-athletes with an ACL-insufficient knee should still choose conservative treatment.

Application of Digital Therapy in Post-operative Rehabilitation of Knee Anterior Cruciate Ligament Reconstruction

Digital therapy is important in treating motor system disease. The outcome of digital therapy in post-operative rehabilitation of knee anterior cruciate ligament (ACL) reconstruction is assessed. 142 patients are treated with digital rehabilitation therapy after ACL reconstruction. Patients' pain score, joint motion, lower limb function score, anxiety score are statistically analyzed. Patients' satisfaction, device usage and adverse events are documented. At post-operative 1st day, 8th weeks, 12th weeks, pain score are 4, 2, 1, knee joint range of motion are 55°, 110°, 143°, lower limb function score are 18, 56, 76, anxiety score are 32.5, 26, 23.5 respectively. Patients' satisfaction are 9.4. Mean duration of device usage is (177.6±38.0) minutes per week. Rehabilitation-related and device-related adverse event does not happen. Digital therapy promotes post-operative rehabilitation after ACL reconstruction.