Prehabilitation enhances functional and structural recovery following anterior cruciate ligament reconstruction: A...

This study aimed to evaluate the effectiveness of an 8-week prehabilitation programme combined with standardized post-operative rehabilitation in improving functional recovery, pain control and structural healing following anterior cruciate ligament reconstruction (ACLR).

A prospective randomized controlled trial was conducted with 90 male patients undergoing primary unilateral ACLR, randomly assigned to either a prehabilitation group (45 patients) or a non-preoperative rehabilitation group (45 patients). The prehabilitation group participated in an 8-week programme including neuromuscular training, strength exercises and education; another group received a home-based exercise programme for 8 weeks, while both groups received identical post-operative rehabilitation. Primary outcomes were measured using the International Knee Documentation Committee (IKDC) score at 12 months, with secondary outcomes including pain levels assessed by the visual analogue scale, Knee injury and Osteoarthritis Outcome Score, functional performance tests and structural assessments through magnetic resonance imaging (MRI). Statistical analyses included repeated-measures analysis of variance, multiple linear regression and Cox proportional hazards models.

At 12-month follow-up, the prehabilitation group demonstrated significantly better outcomes compared to the non-preoperative group: IKDC scores improved by 11.3 points (92.4 vs. 77.1), pain scores were lower (0.0 vs. 1.0) and thigh muscle asymmetry was reduced (0.8 cm vs. 1.5 cm). MRI results also showed better structural healing in the preoperative rehabilitation group. The programme was identified as the strongest predictor of improved knee function and reduced recovery time by 2.6 weeks (7.2 weeks vs. 9.8 weeks).

Preoperative rehabilitation is essential for better recovery after ACLR. These findings support incorporating preoperative rehabilitation into standard treatment protocols. Further research should investigate these effects in broader patient populations and examine underlying biological mechanisms.

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