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Prolonged Physiotherapy after Anterior Cruciate Ligament Reconstruction Does Not Improve Muscular Strength and Function
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International audience. Background: After the rupture of the anterior cruciate ligament (ACL), surgery is proposedin the case of knee instability or for athletes who want to return to a pivotal and/or contact sport.The current trend is to extend physiotherapy sessions until a patient’s return to sport. We aimed toassess the interest in prolonging the physiotherapy sessions up to 4 postoperative months to restoremuscle knee strength and function. Methods: From a historical cohort, 470 patients (24.3 ± 8.7 years)were included; 312 (66%) were males. They all had undergone a primary ACL reconstruction witha hamstring procedure. The number of physiotherapy sessions was established at 4 postoperativemonths. The main study parameters to assess the benefit of prolonged physiotherapy were the isoki-netic limb symmetry index (LSI) for the quadriceps and the hamstrings as well as the Lysholm score.Results: At 4 postoperative months, 148 patients (31.4%) still had physiotherapy sessions. This grouphad performed 49 ± 14 physiotherapy sessions at the time of evaluation compared to 33 ± 9 sessionsperformed by the group that stopped physiotherapy at 3 months post-ACL reconstruction. Theisokinetic knee LSI and the Lysholm score were not different between the two groups. Continuedphysiotherapy sessions were associated with female gender, previous high sport level, meniscal repair,lateral tenodesis and outpatient rehabilitation at the beginning of the rehabilitation management,while knee pain complications were not associated. Conclusions: No significant correlation wasfound between the number of physiotherapy sessions and the knee strength LSI or the Lysholm score.Prolonging patient physiotherapy sessions after 3 months post-ACL reconstruction seems ineffectivein improving knee strength recovery and function.
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