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Clinical improvements found at minimum of 2 months after ACL reconstruction
Approximately 2 months is needed to observe clinically meaningful improvements in patients after ACL reconstruction, according to a cross-sectional case-control study.
A total of 293 patients participated in the study after ACL reconstruction and completed assessments between 5 and 9 months after index surgery. A total of 122 patients had evaluations 5 to 6 months since reconstruction, 102 had evaluations after 6 to 7 months, 43 had evaluations after 7 to 8 months and 26 had evaluations after 8 to 9 months.
Of the 293 patients, 40 (13.65%) followed up for a repeat test to track progress before return to sports. These 40 patients were included in the cohort to determined time-based changes in rehabilitation.
“Time since surgery has been shown to be the most common factor used when making decisions for return to sport after [ACL reconstruction] ACLR,” Stephan G. Bodkin, Med, ATC, of the department of kinesiology at the University of Virginia, and colleagues wrote. “Time following any surgery should be considered, given the healing processes of involved tissues; however, it is often the only criterion used, ignoring the symptomatic state of the patients or objective measures of strength and performance.”
Patients were seen by their surgeons to discuss their lower extremity assessment protocol results and to manage return-to-sport progression. Patients completed the IKDC subjective questionnaire to assess knee function and isokinetic, concentric knee extension and flexion strength was measured with a Biodex System IV dynamometer at a speed of 90° per second.
Results showed subjective function, knee extensor peak torque and knee extensor symmetry were significantly different when compared among months after surgery.
A time of approximately 2 months between visits was found to be necessary minimum time for patients to have a clinically meaningful increase in strength and symmetry. Those assessed between 8 and 9 months after ACLR had higher subjective function and knee extensor measures compared to those assessed approximately 6 months after surgery.
“The results from this study may be used as a clinical target for patients and clinicians seeking an improvement in patient function to manage expectations and guide progressions after ACLR,” the researchers wrote. “By informing patients that 2 months has been shown to be the interval needed to make a clinically meaningful change in testing outcomes, patients and clinicians can have a realistic target.” – by Erin T. Welsh
Disclosures: Bodkin reports no relevant financial disclosures. Please see the study for other authors’ relevant financial disclosures.