Each year in the UK there are around 30 anterior cruciate ligament (ACL) tears per 100,000 people and these account for around 40% of sporting injuries. While an ACL tear does not always require surgical repair, a severe tear can compromise the stability and range of motion of the knee joint, which can impact on sporting performance without appropriate treatment. The outcome of ACL reconstruction is variable and although surgical expertise, such as that offered by Consultant Orthopaedic Surgeon Mr John Hollingdale, increases the chance of regaining full function in the knee joint, other factors also influence the success of this surgical procedure. One of these is whether or not patients receive physical therapy. Research published in the October edition of the British Journal of Sports Medicine provides further insight into the benefits of intensive physiotherapy before and after surgery for ACL reconstruction.

The benefits of pre-operative physiotherapy for knee function and the positive impact this has following ACL reconstruction is already well appreciated. However, there is currently limited long-term evidence for patients who receive enhanced rehabilitation before and after ACL surgery. This encouraged researchers at the Norwegian Research Centre for Active Rehabilitation to investigate the outcome of patients taking part in progressive pre and post-operative rehabilitation compared to standard care. Eighty-four patients aged 16 to 40 awaiting ACL repair were enrolled in the long-term study, which measured their reported outcome before surgery and two years later. Compared to 2690 patients receiving standard care, those who received enhanced physiotherapy before and after the procedure reported significantly better scores for pain, daily activities, sports participation and quality of life, which was mirrored two years post-operatively. At the end of the study up to 94% of patients receiving enhanced care achieved normal scores compared to just 75% of the control group. The superior outcomes achieved through more intensive physiotherapy before and after ACL reconstruction adds weight to its value.

Consultant Orthopaedic Surgeon Mr Hollingdale has more than 20 years of specialist surgical experience performing procedures that involve the knee joint. With a particular interest in the surgical management of sporting injuries he performs in excess of 50 ACL reconstructions every year. His surgical expertise is well-known and his patients include footballers from Arsenal and rugby players from the London Irish team. Mr Hollingdale is available for consultations about prospective ACL repairs at Central Middlesex Hospital and BMI's Clementine Churchill Hospital, and already recommends physiotherapy before and after the procedure to improve surgical outcomes.