The effect of accelerated rehabilitation compared to non-accelerated rehabilitation on patient reported outcomes at 4, 12 and 24 months following Anterior Cruciate Ligament Reconstruction - a randomized controlled trial.

Introduction: Research points out the use of an accelerated protocol but there is still no consensus of what composes the best rehabilitation process, after an anterior cruciate ligament reconstruction (ACLR). Aims: To compare self-reported knee function and activity level after ACLR, using either Hamstrings graft or Patellar BTB graft, with two different types of rehabilitation processes, one group with an accelerated protocol and one group with a non-accelerated protocol. Methods: This study has utilized data collected for a previous prospective Randomized Controlled Trial (RCT) where patients were randomized to an accelerated rehabilitation (n= 81) or to non-accelerated rehabilitation (n=80). The accelerated group was allowed to start Open Kinetic Chain (OKC) exercises, running, and sport-specific drills training earlier, compared to the non-accelerated group. The assessment forms Knee Osteoarthritis Outcome Score (KOOS), Lysholm Score, and Tegner Activity Scale (TAS) were collected at baseline, 4, 12, and 24 months postoperatively. At 24 months, dropout rates were 45 % in the accelerated group and 56 % in the non-accelerated group, wich may have increased the risk of type II errors. Results: Both groups showed improvement from baseline to 24 months on KOOS, Lysholm, and TAS, but no statistically significant difference was observed between the two groups at 4, 12, or 24 months postoperatively. Conclusion: Both an accelerated and a non-accelerated rehabilitation are advantageous after an ACLR according to subjective knee health at 4, 12 and 24 months postoperatively. It was not possible to determine which of the two rehabilitation processes that constitutes the best rehab according to the result of this study as there were no statistical significance difference according to KOOS, TAS or Lysholm score.