Exercise-based rehabilitation for ACL injuries: a systematic review and meta-analysis

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Science

Background:

• Rising rates of anterior cruciate ligament (ACL) reconstruction surgery despite unclear benefits and cost-effectiveness.
• Need for better understanding of exercise efficacy in managing ACL injuries.

Purpose of the Study:

• To evaluate the effectiveness of exercise interventions for individuals with ACL injuries.

Main Methods:

• Systematic review and meta-analysis of 18 randomized trials (1433 participants).
• Searched 5 databases for exercise interventions for ACL injuries.
• Assessed methodological quality, exercise reporting completeness, and certainty of evidence using GRADE.

Main Results:

• Very uncertain benefit of Tai Chi and Pilates over no treatment for pain/recovery; no difference in function.
• Moderate certainty of no difference in function between various exercise types.
• Moderate certainty of no difference in pain between exercise and surgery; small functional benefit for surgery.

Conclusions:

• Exercise provides very uncertain benefits over no treatment for ACL injuries, with no specific exercise type proving superior.
• Surgery offers no advantage in pain management but a minor improvement in function compared to exercise for ACL injuries.