PhysioUpdate 13th September 2022

People with longstanding anterior cruciate ligament (ACL) injuries appear to fare better if they go straight to having reconstructive surgery, rather than following rehabilitation programmes run by physiotherapists first.

That is the conclusion of a team of researchers whose paper was published in The Lancet on 20 August, under the auspices of the University of Oxford-based ACL SNNAp trial. The trial, which is funded by the National Institute for Health and Care Research, could have significant implications for patient outcomes and potentially provide cost savings to healthcare providers.

David Beard, lead author and professor of musculoskeletal and surgical science at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS) said: ‘Although there is good evidence from previous (Scandinavian and Dutch) studies that rehab can be effective for newly injured patients, waiting lists in the NHS for assessment (and treatment) often mean that many patients are seen much further down the line and with a longer-standing injury.'

Professor Beard added: ‘Despite my professional bias toward rehabilitation it became apparent (in my own clinic, and from others) that more longstanding ACL deficient patients did not improve or achieve sufficient knee stability with rehab alone. I was suspicious that these particular patients may be better served by undergoing reconstruction sooner, but a large rigorous trial was needed.’

World Physiotherapy is encouraging its member organisations and physiotherapists around the world to celebrate World PT Day today (8 September). The focus for this year’s World PT Day is osteoarthritis, while the focus shift to other rheumatological conditions next year.

World PT Day World PT Day is held every year on 8 September, the day World Physiotherapy was founded in 1951. The London-based body has a total of 125 member organisations, through which it says it represent 685,00 physiotherapists.

One of the key messages being promoted around the world today is that exercise and physical activities are safe and evidence-based first line management strategies for osteoarthritis. These can delay or prevent joint replacement delay or prevent functional decline reduce joint pain. Osteoarthritis is the most common joint condition, 520 million people have the condition worldwide, a toolkit published in the run-up to today's event noted.