Patient-reported Outcomes and Muscle Strength after a Physiotherapy-led Exercise and Support Brace Intervention in Patients with Acute Injury of the Posterior Cruciate Ligament: A Two-year Follow-up Study.
Randi Gram Rasmussen, Julie Sandell Jacobsen, Birgitte Blaabjerg and 3 others
PMID 37547839WHAT IT FOUND
Patients with acute posterior cruciate ligament injuries who received supervised exercise and a support brace reported substantial improvements in knee function and pain at two years.
Only seven of the fifty patients eventually required surgery. Because there was no control group, these gains cannot be separated from natural healing.
Key findings
01Patient-reported knee function scores improved from a mean of 35 points at baseline to 65 points two years after injury, a change greater than the minimal clinically important difference of 7.0 points.
02Isometric knee flexion strength in the injured leg increased from 0.93 Nm/kg at 16 weeks to 1.1 Nm/kg after one year, while knee extension strength did not change.
03Seven of the fifty patients converted to surgical reconstruction during the study period, with a median time to surgery of 13 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had no control group, so it is impossible to know if the improvements were due to the intervention or natural healing over time. The sample size was small (50 patients), and dropout was high, with only 31 patients completing the two-year follow-up, which reduces statistical power. Baseline knee strength and laxity were not measured for ethical reasons, so changes from the immediate post-injury state cannot be determined. The study population was heterogeneous, including both isolated PCL injuries and more severe multi-ligament injuries, which may affect the generalizability of results to specific subgroups. The physiotherapists who assessed the patients were not blinded to the treatment, which could introduce bias in outcome measurements.
Declared interests
The authors declare that they have no financial or non-financial interests to disclose.
The easy way to misread this
Do not assume that the observed improvements in patient-reported outcomes were caused by the exercise and brace intervention alone. Since there was no control group, these gains could reflect the natural healing process of the posterior cruciate ligament, which is known to have some capacity for self-repair.