Utilization of Rehabilitation Visits and Functional Testing After Anterior Cruciate Ligament Reconstruction

Abstract

Background:

Anterior cruciate ligament (ACL) reconstruction guidelines recommend delaying return to sport until 9 months postsurgery and using functional testing to inform clinical decision-making.

Hypothesis:

Regular rehabilitation visits would continue up to 9 months postsurgery, and most patients would receive functional testing.

Study Design:

Retrospective study.

Level of Evidence:

Level 4.

Methods:

Electronic medical records were reviewed for 338 patients, aged 14 to 21 years, who participated in sports preinjury and had primary ACL reconstruction between January 2017 and December 2018. Of these, 124 patients had all rehabilitation in-system. Rehabilitation visits and time to end of rehabilitation were examined through 12 months postsurgery. The proportion of patients who participated in return-to-sport training, received functional testing, and remained active in rehabilitation up to 9 months postsurgery was calculated.

Results:

Of the total rehabilitation visits, 58.9% occurred in the first 3 months postsurgery. The mean time to end of rehabilitation was 7 months postsurgery. One-third of the patients participated in return-to-sport training, and 72.6% received at least 1 functional test. About 40% of patients were active in rehabilitation up to 9 months postsurgery but visit frequency (<2 times per month) was lower than in return-to-sport training (2 sessions per week).

Conclusion:

Over half of the rehabilitation visits were received in the early phase, and more than half of patients completed rehabilitation before 9 months postsurgery. Return-to-sport training facilitated regular visits in the late phase. About one-quarter of patients had rehabilitation progression without functional testing.

Clinical Relevance:

Study findings illuminate late phase rehabilitation visits and functional testing as potential areas of care delivery to improve for better return-to-sport outcomes after ACL reconstruction.