Patient acceptance of knee symptoms and function after anterior cruciate ligament reconstruction improves with physiotherapy treatment

Abstract

Physiotherapy is considered an important component of rehabilitation following anterior cruciate ligament reconstruction (ACLR). The relationship between physiotherapy treatment and patient-reported outcomes following ACLR in New Zealand (NZ) is not clear. We used repeated measures logistic regression to examine the relationship between patient-reported outcome data from the NZ ACL Registry and physiotherapy treatment data from the Accident Compensation Corporation (ACC). Outcome measures utilised were the patient acceptable symptom state (PASS) on the Knee Injury Osteoarthritis and Outcome Score (KOOS4) and a normative score on the Marx Activity Rating Scale (MARS) within 24 months of ACLR. Data from 5,345 individuals were included in the final analysis, with a mean (SD) of 11.7 (10.5) (range 0–91) physiotherapy treatments received, over an average (SD) of 185 (153) (range 0–725) days, in the two years following ACLR. Physiotherapy treatment post-ACLR increased the likelihood of achieving a KOOS4 PASS score at 6 and 12 months, but not at 24 months, following surgery. Physiotherapy did not increase the likelihood of achieving a normative MARS score in the 24 months after ACLR. Multiple factors likely contribute to people who have had an ACLR in NZ receiving a low dosage of physiotherapy treatment following surgery. Physiotherapy treatment after ACLR may increase patient acceptance of any post-surgical symptoms and functional limitations, but the effect on post-operative activity levels is less clear.