# Clinical Outcomes in Patients Undergoing Anterior Cruciate Ligament Reconstruction With Controlled Accelerated Rehabilitation

## TL;DR

This study examines clinical outcomes of patients who underwent ACL reconstruction with a controlled accelerated rehabilitation program, showing most achieved good or excellent results.

## Contribution

The study provides new clinical evidence on the effectiveness of a modified controlled accelerated rehabilitation program after ACL reconstruction.

## Key findings

- 96% of patients achieved excellent or good clinical outcomes based on physical examination.
- 98% of patients showed excellent or good results using Lysholm and IKDC scoring systems.
- Tegner activity scores significantly increased post-surgery, indicating improved activity levels.

## Abstract

Background

An anterior cruciate ligament (ACL) tear is one of the most common sports injuries in the knee region. Currently, anatomical ACL reconstruction with quadrupled hamstring tendon autograft and controlled accelerated rehabilitation is a frequently used treatment approach. This study aims to add to the literature the early and mid-term clinical results of the controlled accelerated rehabilitation program we implemented in our clinic to enable patients to return to their daily activities faster after ACL reconstruction.

Methodology

In this retrospective study, 51 patients (50 males, 1 female) diagnosed with ACL tear and undergoing ACL reconstruction with quadrupled hamstring tendon graft were included in our study. In the femoral fixation of the graft, the transfix method was used in 22 patients and the Endobutton-CL method was used in 29 patients. A controlled accelerated rehabilitation program developed by Shelbourne was employed with some modifications to the patients. Clinical evaluation of patients was performed using Lysholm, Cincinnati, Tegner, and International Knee Documentation Committee (IKDC) scoring systems.

Results

The mean postoperative follow-up period was 18.7 months (range = 6-36 months). During the physical examination, Lachman, anterior drawer, and pivot shift, 49 (96%) patients achieved excellent or good results, while only two (5%) patients experienced fair clinical outcomes. On clinical assessment using the Lysholm and IKDC scoring systems, 50 (98%) patients demonstrated excellent or good results, whereas only one (2%) patient showed fair results. Excellent and good outcomes were observed in all patients using the Cincinnati scoring system. We found a significant decrease in Tegner activity score pre-surgery, which significantly increased post-surgery.

Conclusions

The combination of Endobutton and cross-pin for femoral fixation and staples and interference screw for tibial fixation is thought to be safe in patients undergoing controlled accelerated rehabilitation after ACL reconstruction. The implementation of controlled accelerated rehabilitation enables patients to return to their social lives earlier without resulting in clinically poor outcomes in grafts and implants applied in the early and middle stages.