Lower extremity performance following ACL rehabilitation in the KANON-trial: impact of reconstruction and predictive value at 2 and 5 years

Ylva B Ericsson, Ewa M. Roos, Richard B Frobell

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: The additional effect of anterior cruciate ligament (ACL) reconstruction on muscle strength and physical performance after a structured exercise programme is not well understood.

OBJECTIVES: To investigate and compare muscle strength and physical performance test results after a structured exercise programme, in young active adults with acute ACL injury, between those treated with and without ACL reconstruction (ACLR) and to evaluate these test results as predictors of clinical outcomes 2 and 5 years after injury.

STUDY DESIGN: Prospective cohort study.

METHODS: In a treatment randomised controlled trial of acute ACL injury (the KANON-study), 87/121 young active adults underwent two muscle strength tests and five physical performance tests after a structured exercise programme (median 37 (IQR 24) weeks after injury). Results were presented and compared as limb symmetry indices (LSI); endpoints in predictive analyses were having a delayed ACLR over the first 5 years and self-reported knee function (Knee injury and Osteoarthritis Outcome Score; KOOS4) at 2 and 5 years.

RESULTS: Overall, 74-95% of patients had LSI≥90% in the individual tests, with no difference between treatment groups (p=0.08-0.92). Results of the one-leg rise tests predicted KOOS₄ at 2 and 5 years (R²=0.25 and 0.24, p=0.001 and 0.002) and vertical hop results predicted having a delayed ACLR over a 5-year course after injury (p=0.048) in those starting with exercise alone (n=21).

CONCLUSIONS: After an acute ACL tear, the majority of young active adults regain physical performance and muscle strength after a structured exercise programme, with or without surgical reconstruction. Poor physical performance at the end of rehabilitation predicted worse patient-reported outcomes at 2 and 5 years regardless of treatment.

REGISTRATION NUMBER: ISRCTN84752559.

Original languageEnglish
JournalBritish Journal of Sports Medicine
Volume47
Issue number15
Pages (from-to)980-985
Number of pages6
ISSN0306-3674
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Adult
  • Anterior Cruciate Ligament Injuries
  • Anterior Cruciate Ligament Reconstruction/rehabilitation
  • Anterior Cruciate Ligament/physiology
  • Exercise Test
  • Exercise Therapy/methods
  • Humans
  • Knee Joint/physiology
  • Leg/physiology
  • Muscle Strength/physiology
  • Prospective Studies
  • Psychomotor Performance/physiology
  • Recovery of Function/physiology
  • Rupture/physiopathology

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