Utilization of a 3D Printed Customized Knee Extender Device and An At-Home Video Rehabilitation Program on Patient Outcomes in Rural Areas Following ACL Surgery

Background Physical therapy is a critical component of postoperative rehabilitation after ACL surgery. However, access to formal physical therapy is not universal, and patients who do not receive adequate rehabilitation may experience worse postoperative outcomes. The primary objective of this study was to evaluate whether the addition of a low-cost, desktop 3D-printed knee extension device and at-home video program led to an increased rate of obtaining full knee extension following anterior cruciate ligament reconstruction in the early postoperative period. Hypothesis/Purpose: We hypothesized that there would be no difference in the percentage of patients achieving full knee extension by six weeks or in overall knee range of motion between the study and control groups. Secondary outcomes included device compliance, device issues, knee effusion, pain levels, usage characteristics, and skin/wound reactions. Methods This was a prospective, randomized, controlled pilot study. 32 participants aged 15–48 years with primary ACL ruptures were enrolled and randomized into two groups: a control group that received standard postoperative physical therapy rehabilitation, and an experimental group that received the same rehabilitation supplemented with a knee extension device and an at-home, video-guided exercise program. Patients were assessed over a 6-week postoperative period, recording knee circumference, range of motion, pain scores, time to full extension, safety, and device-related issues. Categorical variables were analyzed using chi-squared tests, and continuous variables were analyzed using t-tests and ANOVA. Results There were no differences between groups in six-week knee range of motion, knee circumference, pain scores, or time to full knee extension. Although a greater proportion of patients in the experimental group achieved full extension by Week 2, this difference was not statistically significant (p = 0.70). No adverse outcomes were reported in either group. Conclusion Overall, there were no statistically significant differences in outcomes between the control and study group. This study found that incorporating an at home video program and a custom low-cost desktop 3D printed knee sling into the postoperative ACL rehabilitation was safe, utilized appropriately, and had excellent patient compliance.