Effect of physiotherapy attendance on outcome after anterior cruciate ligament reconstruction: a pilot study

Background: In many centres patients are routinely referred for physiotherapy after anterior cruciate ligament (ACL) reconstruction. However, to date the role and amount of supervised physiotherapy required has not been clearly established. Objective: To establish whether there was any difference in outcome between a group of patients who attended physiotherapy regularly after ACL reconstruction and a group who attended only infrequently. Methods: Ten patients who had attended physiotherapy infrequently ( mean 1.9 visits) during the first six months after ACL reconstructive surgery were matched for age, sex, graft type, and activity level and occupation before injury with 10 patients who had attended physiotherapy regularly ( mean 26.5 visits). Outcome was assessed at 12 months using the Cincinnati knee rating system and the IKDC form. Results: Compared with the regular physiotherapy group, patients in the minimal physiotherapy group had fewer symptoms ( mean Cincinnati symptom score 46.2 v 43.4, p = 0.045). There was also a trend towards higher overall Cincinnati knee scores in the minimal physiotherapy group ( mean 93.7 v 87.3, p = 0.06) but no difference in IKDC ratings. Conclusion: These preliminary results indicate that some patients who choose to attend physiotherapy on a very limited basis after ACL reconstruction can achieve satisfactory, if not better, outcomes than patients who attend physiotherapy regularly.