Postoperative anterior cruciate ligament rehabilitation: A survey in Gauteng, South Africa

Abstract

Background: Post-operative rehabilitation is key to successful outcomes in anterior cruciate ligament (ACL) surgery. This study aimed to determine the management strategies (accelerated vs. non-accelerated protocols) and treatment modalities used by physiotherapists for post-operative ACL rehabilitation in Gauteng, South Africa.

Objectives: This study determined the frequency of accelerated and non-accelerated protocols, identified rehabilitation objectives, commonly used physiotherapy modalities and exercise recommendations within the first 6 weeks of post-operative ACL rehabilitation.

Method: A cross-sectional study was carried out between 15 December 2021 and 27 May 2022, using a custom-designed questionnaire. The survey was initially distributed to members of the South African Society of Physiotherapy (SASP) and Physiotherapy Association of South Africa (PASA), as well as shared on social media platforms. Data collection was completed in 6 months. Descriptive statistics (frequencies means and percentages) were analysed.

Results: Out of 120 responses received, 47% (56) were analysed. Management strategies included the accelerated and non-accelerated programmes: 70% (39) of the participants used the accelerated protocol and 23% (13) used the non-accelerated protocol. Furthermore, 59% used protective bracing as part of their management and 66% (37) started rehabilitation post-operatively. Treatment modalities used included myofascial release (75%, 41), peripheral joint mobilisation (63%, 35), massage (57%, 32) and cryotherapy (34%, 19).

Conclusion: Remarkable variation was found in treatment protocols, modalities and exercise prescription.

Clinical implications: Using clinical evaluation, objective outcome measures and functional tests as an objective criterion is crucial in decision-making regarding return to function and sport.