AVON ACL Study
Research type
Research Study
Full title
Accelerated versus non-accelerated rehabilitation after anterior cruciate ligament reconstruction: a pilot study
IRAS ID
154133
Contact name
Ruth Halliday
Contact email
Sponsor organisation
North Bristol NHS Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
The anterior cruciate ligament (ACL) is a vital structure within the knee that provides the stability of the joint. Injury to the ACL is a common injury of the knee affecting young adults, usually whilst playing sport.
Surgical reconstruction of complete ACL rupture aims to restore stability of the knee, reduce pain and swelling, limit future arthritic change, maximise knee function and allow patients to return to pre-injury recreational and sporting activity. It has been suggested that the success of an ACL reconstruction is dependent upon the post-operative rehabilitation process.
There is no consensus on the best rehabilitation following ACL reconstruction. Traditional, non-accelerated, rehabilitation programmes emphasise protection of the ACL graft, modelled on the stages of graft healing. This includes post-operative immobilisation, limiting how much the knee can be straightened, restricted weight bearing and delayed return to activity with most patients returning to activity at 1 year. Complications have however been identified with non-accelerated rehabilitation. This includes ongoing muscle weakness, inability to fully straighten the knee, and knee cap pain at 1 year follow-up. To address these issues alternative, accelerated, rehabilitation programmes have been developed. These have included allowing full movement, earlier weight bearing and earlier return to activity, with no adverse sequalae.
The uncertainty in the benefit of accelerated rehabilitation over conventional non-accelerated protocols warrants further investigation in order determine whether accelerated protocols improve knee muscle function and clinical outcome in the long-term, and provide a more effective practice for treating patients following ACL reconstruction, or whether they pose an increased risk of re-injury by permitting early return to higher level activity. This study is a single centre randomized controlled trial comparing accelerated versus non-accelerated rehabilitation protocols with the use of clinical and patient reported outcome measures over a 15-month period following ACL reconstruction.
REC name
Wales REC 4
REC reference
14/WA/1171
Date of REC Opinion
25 Sep 2014
REC opinion
Favourable Opinion