2025 ISAKOS Biennial Congress ePoster
Cross-Sectional Outcomes After Treatment With Acl Reconstruction Compared With Rehabilitation Alone During The First 12 Months Of Treatment After Acl Injury
Ramana Piussi, PhD, Göteborg, Sverige SWEDEN
Rebecca Simonson SWEDEN
Roland Thomee, Professor, Rönnäng SWEDEN
Kristian Samuelsson, Prof, MD, PhD, MSc, Mölndal, Västra Götalands län SWEDEN
Eric Hamrin Senorski, PT, PhD, Assoc. Prof., Västra Frölunda SWEDEN
Neuroscience and physiology, Gothenburg University, Gothenburg, SWEDEN
FDA Status Not Applicable
Summary
This study compares muscle function and patient-reported outcomes between ACL reconstruction and rehabilitation-only treatments, revealing that while reconstruction leads to greater absolute strength and higher self-reported outcomes, rehabilitation alone achieves better limb symmetry.
ePosters will be available shortly before Congress
Abstract
Background
Anterior Cruciate Ligament (ACL) injuries are commonly treated either with surgical reconstruction followed by rehabilitation or with rehabilitation alone. While reconstruction is often favored, there is limited research on outcomes for patients treated with rehabilitation alone. This study aims to compare muscle function, return to knee-strenuous sports, and patient-reported outcomes between patients treated with ACL reconstruction and patients treated with rehabilitation alone during the first year after ACL injury.
Method
This prospective cross-sectional study included 2,536 patients from the Project ACL registry, divided into two groups: 362 patients treated with rehabilitation alone and 2,174 patients treated with ACL reconstruction. Muscle strength tests for quadriceps and hamstrings were performed at 10 weeks, 4, 8, and 12 months post-injury/reconstruction. Patient-reported outcomes (PROs) were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS), Knee Self-Efficacy Scale (K-SES), ACL Return to Sport after Injury Scale (ACL-RSI), and Tegner activity scale.
Results
Patients treated with ACL reconstruction generally exhibited greater absolute muscle strength in the uninjured limb at all follow-ups but displayed less symmetrical strength compared to patients treated with rehabilitation alone. The reconstruction group reported higher scores in PROs, including KOOS subscales for pain, symptoms, and sports, as well as higher self-efficacy and confidence in returning to sports. However, the differences in KOOS scores were below the minimal clinically important differences (MCID), indicating limited clinical significance. Patients treated with rehabilitation alone showed better limb symmetry in muscle strength but had lower absolute strength.
Conclusion
The study suggests that while patients treated with ACL reconstruction tend to have greater absolute muscle strength and higher patient-reported outcomes, rehabilitation alone results in better limb symmetry. Despite these differences, the clinical significance of improved KOOS scores in the reconstruction group is limited.