Rehabilitation after ACL injury and reconstruction from the patients perspective

Objectives: To describe and compare patients appraisal of the rehabilitation and adherence to the rehabilitation program after acute ACL injury treated with (ACLR) or without (non-ACLR) reconstruction. Design: Prospective cohort study. Participants: 275 patients (143 females; mean age 25 +/- 7 years) with acute ACL injury, of whom 166 patients had ACLR within 24 months. Main outcome: Adherence to rehabilitation was assessed using the modified Sports Injury Rehabilitation Adherence Scale (SIRAS). Results: Appraisal of rehabilitation was higher in the post-ACLR group compared to the non-ACLR group at 3 months (91% compared to 70% scored rehabilitation as necessary, p = 0.025) and at 6 months (87% compared to 70% scored it as necessary, p = 0.017). SIRAS score did not differ between 3 and 6 months for the non-ACLR group (median (IQR) 13 (2) vs 13 (2)) or the post-ACLR group (14 (1) vs 14 (2), p>0.05). The post-ACLR group had a higher SIRAS score than the non-ACLR group at 3 and 6 months (p ≤0.001). Conclusion: Patients treated with ACLR reported valuing their rehabilitation more and rated greater adherence to the rehabilitation programme than non-surgically treated patients. As rehabilitation is essential for good knee function, strategies to improve adherence after non-ACLR treatment should be implemented.Funding Agencies: Swedish Medical Research Council (SMRC)European Commission [VR 2015-03687, VR 2018-02563]; Swedish Research Council for Sport Science (CIF) [P2017-0151, P2018-0132, P2019-0071]; Medical Research Council of Southeast Sweden, UK Research & Innovation (UKRI)Medical Research Council UK (MRC) [FORSS 662081]; ALF Grants Region Östergotland [LIO-798907, 900721, 934538]