National University Hospital Sports Centre, Department of Orthopaedic Surgery, National University Health System, Singapore.
Department of Rehabilitation, National University Hospital Sports Centre, National University Health System, Singapore.
Orthop J Sports Med. 2015 Dec 10;3(12):2325967115620770. doi: 10.1177/2325967115620770. eCollection 2015 Dec.
Successful return to sport is an important outcome measure after anterior cruciate ligament (ACL) reconstruction and a reason for patients' decisions to elect surgery. Rehabilitation programs supervised by physical therapists are routinely prescribed after ACL reconstruction surgery. However, the added advantage of supervised physical therapy after ACL reconstruction is still debatable.
Attending more supervised physical therapy sessions after arthroscopic ACL reconstruction in recreational athletes increases their chance of successful return to sport.
Cohort study; Level of evidence, 3.
The authors analyzed 93 recreational athletes who underwent arthroscopic ACL reconstruction. After arthroscopic single-bundle ACL reconstruction, patients were advised to attend 20 supervised physical therapy sessions. Patients' demographics, surgical details, and outcome measures (Knee injury and Osteoarthritis Outcome Score [KOOS], Lysholm scale, and Short Form-36 Health Survey [SF-36]) were recorded presurgery and at 1-year follow-up. Ability to return to sports was documented through patients' self-report. The attendance at physical therapy by each patient was obtained by examining database records and assessed as fully compliant (>15 sessions), moderately compliant (6-15 sessions), or noncompliant (<6 sessions).
Patients in the fully compliant group had significantly greater odds (odds ratio [OR], 18.5; 95% CI, 1.9-184.5; P = .013) of a successful return to sport as compared with the noncompliant group. Patients in the moderately compliant group also had greater odds of returning to sport as compared with the noncompliant group (OR, 4.2; 95% CI, 1.0-16.6; P = .043). Patients in the fully compliant group had significantly greater scores on the Lysholm (P < .001), KOOS Sports and Recreation subscale (P = .021), KOOS Symptoms subscale (P = .040), and SF-36 physical component summary (PCS) (P = .012) as compared with the noncompliant group. Moderately compliant patients had significantly greater scores on the Lysholm (P = .004), KOOS Sports and Recreation (P = .026), KOOS Symptoms (P = .041), KOOS Quality of Life (P = .022), and SF-36 PCS (P = .004) as compared with noncompliant patients.
In recreational athletes, moderate to full compliance with a supervised physical therapy program predicts improved knee function and a greater chance of returning to sport 1 year after ACL reconstruction.
前交叉韧带（ACL）重建后，成功重返运动是一个重要的预后指标，也是患者选择手术的原因。ACL 重建手术后，患者通常需要接受物理治疗师监督下的康复计划。然而，ACL 重建后接受监督物理治疗的额外益处仍存在争议。
在接受关节镜 ACL 重建的娱乐性运动员中，增加接受监督物理治疗的次数可增加其重返运动的成功率。
队列研究；证据水平，3 级。
作者分析了 93 名接受关节镜 ACL 重建的娱乐性运动员。在关节镜下单束 ACL 重建后，建议患者接受 20 次监督物理治疗。记录患者的人口统计学、手术细节和结果测量（膝关节损伤和骨关节炎结果评分[KOOS]、Lysholm 量表和健康调查简表-36[SF-36]），术前和 1 年随访时进行记录。通过患者的自我报告记录运动的恢复情况。通过检查数据库记录来获取每位患者的物理治疗出勤率，并评估为完全依从（>15 次）、中度依从（6-15 次）或不依从（<6 次）。
与不依从组相比，完全依从组患者重返运动的可能性显著更高（优势比[OR]，18.5；95%置信区间，1.9-184.5；P =.013）。中度依从组患者重返运动的可能性也高于不依从组（OR，4.2；95%置信区间，1.0-16.6；P =.043）。与不依从组相比，完全依从组患者的 Lysholm（P <.001）、KOOS 运动和娱乐亚量表（P =.021）、KOOS 症状亚量表（P =.040）和 SF-36 生理成分综合评分（PCS）（P =.012）显著更高。中度依从患者的 Lysholm（P =.004）、KOOS 运动和娱乐（P =.026）、KOOS 症状（P =.041）、KOOS 生活质量（P =.022）和 SF-36 PCS（P =.004）得分显著高于不依从患者。
在娱乐性运动员中，中等至完全依从监督物理治疗方案可预测 ACL 重建后 1 年膝关节功能的改善和重返运动的机会增加。
