Only 1 in 10 patients achieve their rehabilitation goals at 1 year and 1 in 4 at 2 years following ACL reconstruction: An analysis of 907 patients.

Purpose: The aim of this study was to describe and compare demographic characteristics, perceived knee function and muscle function between patients who achieved their rehabilitation goals and those who did not at 1 and 2 years after anterior cruciate ligament (ACL) reconstruction. Methods: Data on patient demographics, results from patient-reported outcomes (PROs), muscle strength and hop performance tests were extracted from Project ACL in April 2024. Patients treated with primary ACL reconstruction, ≥15 years of age at surgery, with complete data from PROs, muscle strength and hop performance tests at 1 or 2 years after surgery were included. The outcomes included comparisons of (1) demographics, (2) PROs and (3) muscle function tests between patients who achieved and those who did not achieve their rehabilitation goals at 1 and 2 years after ACL reconstruction. Alpha level was set at p < 0.05. Results: At 1 year, 762 patients were included of whom 100 patients (13%) achieved their rehabilitation goals. At 2 years, 145 patients were included, of whom 40 patients (28%) achieved their rehabilitation goals. Patients who achieved their rehabilitation goals at 1 year and 2 years reported less severe perceived knee symptoms (d = 0.24-0.46), greater perceived knee function (d = 0.52-0.77), greater knee related self-efficacy (d = 0.42-0.68), more positive emotions, greater confidence and higher risk appraisal to return to sport (d = 0.47-0.82), and were active at a higher physical activity level (p < 0.001), despite lower set rehabilitation goals than patients who did not achieve their rehabilitation goals. Conclusions: Patients who achieve their rehabilitation goals after ACL reconstruction are characterized by higher perceived knee function, less severe knee symptoms, higher knee self-efficacy, more positive emotions, stronger confidence and higher risk appraisal to return to sport and engage in higher activity levels compared to patients who did not achieve their rehabilitation goals. Level of Evidence: Level III, retrospective observational registry study.