Comparison of Early Versus Delayed Rehabilitation Following ACL Reconstruction

Abstract

Background: Anterior cruciate ligament (ACL) injury is a common orthopedic condition affecting physically active individuals and often results in knee instability, reduced functional capacity and impaired quality of life. Postoperative rehabilitation plays a crucial role in recovery following ACL reconstruction. However, the optimal timing of rehabilitation initiation remains controversial, particularly in resource-limited settings such as Bangladesh. This study aimed to compare the functional outcomes and postoperative complications between early and delayed rehabilitation following ACL reconstruction.

Methods: This comparative observational study was conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January to December 2021. A total of 60 patients undergoing primary unilateral arthroscopic ACL reconstruction were enrolled and divided equally into early rehabilitation (n=30) and delayed rehabilitation (n=30) groups. Functional outcomes were assessed using IKDC, Lysholm, Tegner activity, VAS pain scores, knee range of motion and postoperative stability tests. Statistical analysis was performed using SPSS version 25.0.

Results: Baseline characteristics were comparable between the groups. At six months, the early rehabilitation group demonstrated significantly higher IKDC scores (84.6±6.8 vs 78.2±7.5; p=0.001), Lysholm scores (89.1±5.9 vs 82.7±6.7; p<0.001), Tegner activity scores (6.2±1.1 vs 5.4±1.0; p=0.006) and greater knee flexion range of motion (132.4±7.1° vs 125.8±8.3°; p=0.002). Lower VAS pain scores and fewer postoperative complications were also observed in the early rehabilitation group.

Conclusion: Early rehabilitation following ACL reconstruction resulted in better functional recovery and lower complication rates than delayed rehabilitation.