Supervised Physiotherapy Wins after ACL Repair Save

This was a parallel-group randomized trial of 184 young adults (18-40 years) with persistent knee problems 9 to 36 months after ACLR. they were randomized to either4-month twice-weekly physiotherapist-supervised exercise therapy program with education (SUPER [SUpervised exercise-therapy and Patient Education Rehabilitation]; n = 92) or a single physiotherapist-delivered education session and self-directed exercise resource (control; n = 92). The primary outcome was 4-month change in the composite Knee injury and Osteoarthritis Outcome Score (KOOS₄; 0 = worst, 100 = best). 

 

A total of 184 ACLR patients (mean 30 years; 2.2 years post ACLR) ernrol with >95% completing the 4-month and 12-month follow-up. At 4 months, KOOS₄ scores improved more in the SUPER group than in the control group (14.1 vs. 9.4). The minimal clinically important difference in KOOS is generally 8-17 points. 

 

At 4 months, SUPER resulted in greater muscle strength gains and higher rates of success on global rating of change (for example, pain 73% vs. 40%). Between-group differences narrowed at 12 months as the control group continued to improve, whereas SUPER gains were sustained. 

 

For young adults with persistent knee problems after ACLR, physiotherapist-supervised exercise therapy with education lead to faster improvement compared to self-directed exercise. But these between-group differences may not be sustained over time.