Review Article | | Peer-Reviewed

Evaluating Post-Surgical Recovery in ACL Repair: A Meta-Analytical Review of Preoperative Therapy Versus Non-Therapeutic Approaches

Received: 24 March 2025     Accepted: 15 April 2025     Published: 24 May 2025
Views:       Downloads:
Abstract

Background: Preoperative therapy has been increasingly proposed as a strategy to optimize recovery outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction. This meta-analysis aimed to evaluate the effectiveness of preoperative therapeutic interventions compared to non-therapeutic approaches in enhancing post-surgical recovery. Methods: A systematic review of the literature was conducted, and eligible studies that compared preoperative therapy with non-therapeutic approaches in ACL repair were identified. Data were extracted on various clinical outcomes, including knee mobility, overall knee function, and patient-reported quality of life. The methodological quality of the studies was rigorously assessed and a meta-analytical synthesis was performed. Findings: The results revealed that patients receiving preoperative therapy exhibited superior knee mobility and overall knee health post-surgery. However, improvements in overall knee function were similar between the two groups, suggesting that preoperative therapy may have a targeted benefit on specific functional parameters rather than a global impact. Conclusion: Preoperative therapeutic interventions appear to offer significant advantages in terms of knee mobility and overall knee health in the context of ACL reconstruction, although both preoperative and non-therapeutic approaches yield comparable results in overall knee function. These findings underscore the potential of tailored preoperative strategies to enhance targeted aspects of post-surgical recovery. Further research is warranted to identify the most effective components of preoperative therapy and their long-term impacts on patient outcomes. Additionally, integrating patient-specific factors into the design of preoperative protocols could optimize recovery trajectories and improve personalized care in ACL reconstruction.

Published in American Journal of Sports Science (Volume 13, Issue 2)
DOI 10.11648/j.ajss.20251302.13
Page(s) 39-49
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Anterior Cruciate Ligament Reconstruction, Preoperative Therapy, Knee Mobility, Post-surgical Recovery

References
[1] Jiménez-Martínez J, Gutiérrez-Capote A, Alarcón-López F, Leicht A, Cárdenas-Vélez D. Relationship between cognitive demands and biomechanical indicators associated with anterior cruciate ligament injury: a systematic review. Sports Medicine. 2025; 55(1): 145-65.
[2] Cattano NM, Magee D, Clark KP, Smith J. Cartilage Deformation, Outcomes, and Running Force Comparisons in Females With and Without Knee Injuries. Journal of Sport Rehabilitation. 2025; 1(aop): 1-8.
[3] Cognetti DJ, Defoor MT, Yuan TT, Sheean AJ. Knee Joint Preservation in Tactical Athletes: A Comprehensive Approach Based upon Lesion Location and Restoration of the Osteochondral Unit. Bioengineering. 2024; 11(3): 246.
[4] Piedade SR, Arruda BPL, de Vasconcelos RA, Parker DA, Maffulli N. Rehabilitation following surgical reconstruction for anterior cruciate ligament insufficiency: what has changed since the 1960s?—state of the art. Journal of ISAKOS. 2023; 8(3): 153-62.
[5] Punnoose A, Claydon-Mueller LS, Weiss O, Zhang J, Rushton A, Khanduja V. Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis. JAMA network open. 2023; 6(4): e238050-e.
[6] Jester R. Rehabilitation and the orthopaedic and musculoskeletal trauma patient. Orthopaedic and Trauma Nursing: An Evidence‐based Approach to Musculoskeletal Care. 2023: 62-71.
[7] Peer M. Peri-surgical changes in functional capabilities associated with reconstructive knee surgery 2017.
[8] Eitzen I, Holm I, Risberg MA. Preoperative quadriceps strength is a significant predictor of knee function two years after anterior cruciate ligament reconstruction. British journal of sports medicine. 2009; 43(5): 371-6.
[9] Fleurent-Grégoire C. Towards consensus of reported outcomes and a common definition of surgical prehabilitation. 2024.
[10] Giesche F, Niederer D, Banzer W, Vogt L. Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review. PloS one. 2020; 15(10): e0240192.
[11] Zheng Y, Huang Z, Dai L, Liu Y, Chen Y, Zhang W, et al. The effect of preoperative rehabilitation training on the early recovery of joint function after artificial total knee arthroplasty and its effect evaluation. Journal of Healthcare Engineering. 2022; 2022(1): 3860991.
[12] Trottier M, Carli F. Preoperative optimization: physical and cognitive pre-habilitation and management of chronic medication. Saudi Journal of Anaesthesia. 2023; 17(4): 500-8.
[13] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. International journal of surgery. 2021; 88: 105906.
[14] Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of epidemiology & community health. 1998; 52(6): 377-84.
[15] Radzimski AO, Mündermann A, Sole G. Effect of footwear on the external knee adduction moment—a systematic review. The knee. 2012; 19(3): 163-75.
[16] Amaravati RS, Sekaran P. Does preoperative exercise influence the outcome of ACL reconstruction? Arthroscopy. 2013; 29(10): e182-e3.
[17] Failla MJ, Logerstedt DS, Grindem H, Axe MJ, Risberg MA, Engebretsen L, et al. Does extended preoperative rehabilitation influence outcomes 2 years after ACL reconstruction? A comparative effectiveness study between the MOON and Delaware-Oslo ACL cohorts. The American journal of sports medicine. 2016; 44(10): 2608-14.
[18] Grindem H, Granan L-P, Risberg MA, Engebretsen L, Snyder-Mackler L, Eitzen I. How does a combined preoperative and postoperative rehabilitation programme influence the outcome of ACL reconstruction 2 years after surgery? A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian National Knee Ligament Registry. British journal of sports medicine. 2015; 49(6): 385-9.
[19] Reddy D, Kamath S, Annappa R, Krishnamurthy S, Kamath K, Mallya S. Does preoperative rehabilitation give better short term results in anterior cruciate ligament reconstruction. Ambul Surg. 2020; 26(02): 40-3.
[20] Dai Haojie YL, Bhattacharya T. Combined Impact of Chinese Exercise and Electrotherapy on Improving Range of Motion in Anterior Cruciate Ligament (ACL) Injury Patients: A Study Conducted at Rehabilitation Centers in Beijing. 2025.
[21] Alit Pawana IP. The Importance of Preoperative Rehabilitation in Knee Ligament Reconstruction Surgery. Orthopaedic Journal of Sports Medicine. 2024; 12(10_suppl3): 2325967124S00390.
[22] Simonsson R, Högberg J, Lindskog J, Piussi R, Sundberg A, Sansone M, et al. A comparison between physical therapy clinics with high and low rehabilitation volumes of patients with ACL reconstruction. Journal of Orthopaedic Surgery and Research. 2023; 18(1): 842.
[23] McGough JJ, Faraone SV. Estimating the size of treatment effects: moving beyond p values. Psychiatry (Edgmont). 2009; 6(10): 21.
[24] Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Bmj. 2003; 327(7414): 557-60.
[25] Letchford R. A study of functional recovery following anterior cruciate ligament reconstruction: Cardiff University; 2015.
[26] Gil JN, Gray CF, Prieto HA, Parvataneni HK, Miley EN, Rutledge RS, et al. Impact of Range of Motion Trajectory on Patient-Reported Outcomes Following Total Knee Arthroplasty. The Journal of Arthroplasty. 2025.
[27] Burnel J, Chamu T, Bonin N, Van Cant J, De Fontenay BP. Strength, mobility, and functional outcomes 2.5 months after hip arthroscopy for femoroacetabular impingement syndrome: A Cross-sectional Study. Physical Therapy in Sport. 2025; 71: 43-52.
[28] Floyd SB, Ahearn B, Kissenberth MJ, Brooks JM, Thigpen CA. Ranking Surgeon Performance After ACL Reconstruction Using the Knee Injury and Osteoarthritis Outcome Score (KOOS) Subscales. Orthopaedic Journal of Sports Medicine. 2025; 13(1): 23259671241298993.
[29] Ghaffari S, Razavipour M, Taheri S, Nazari F, Gharib M. Validation and reliability of the Persian version of the Knee Injury and Osteoarthritis Outcome Score Patellofemoral questionnaire for Iranian patients with patellofemoral pain. International Journal of Therapy And Rehabilitation. 2025; 32(1): 1-10.
Cite This Article
  • APA Style

    Piri, E. (2025). Evaluating Post-Surgical Recovery in ACL Repair: A Meta-Analytical Review of Preoperative Therapy Versus Non-Therapeutic Approaches. American Journal of Sports Science, 13(2), 39-49. https://doi.org/10.11648/j.ajss.20251302.13

    Copy | Download

    ACS Style

    Piri, E. Evaluating Post-Surgical Recovery in ACL Repair: A Meta-Analytical Review of Preoperative Therapy Versus Non-Therapeutic Approaches. Am. J. Sports Sci. 2025, 13(2), 39-49. doi: 10.11648/j.ajss.20251302.13

    Copy | Download

    AMA Style

    Piri E. Evaluating Post-Surgical Recovery in ACL Repair: A Meta-Analytical Review of Preoperative Therapy Versus Non-Therapeutic Approaches. Am J Sports Sci. 2025;13(2):39-49. doi: 10.11648/j.ajss.20251302.13

    Copy | Download

  • @article{10.11648/j.ajss.20251302.13,
      author = {Ebrahim Piri},
      title = {Evaluating Post-Surgical Recovery in ACL Repair: A Meta-Analytical Review of Preoperative Therapy Versus Non-Therapeutic Approaches
    },
      journal = {American Journal of Sports Science},
      volume = {13},
      number = {2},
      pages = {39-49},
      doi = {10.11648/j.ajss.20251302.13},
      url = {https://doi.org/10.11648/j.ajss.20251302.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajss.20251302.13},
      abstract = {Background: Preoperative therapy has been increasingly proposed as a strategy to optimize recovery outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction. This meta-analysis aimed to evaluate the effectiveness of preoperative therapeutic interventions compared to non-therapeutic approaches in enhancing post-surgical recovery. Methods: A systematic review of the literature was conducted, and eligible studies that compared preoperative therapy with non-therapeutic approaches in ACL repair were identified. Data were extracted on various clinical outcomes, including knee mobility, overall knee function, and patient-reported quality of life. The methodological quality of the studies was rigorously assessed and a meta-analytical synthesis was performed. Findings: The results revealed that patients receiving preoperative therapy exhibited superior knee mobility and overall knee health post-surgery. However, improvements in overall knee function were similar between the two groups, suggesting that preoperative therapy may have a targeted benefit on specific functional parameters rather than a global impact. Conclusion: Preoperative therapeutic interventions appear to offer significant advantages in terms of knee mobility and overall knee health in the context of ACL reconstruction, although both preoperative and non-therapeutic approaches yield comparable results in overall knee function. These findings underscore the potential of tailored preoperative strategies to enhance targeted aspects of post-surgical recovery. Further research is warranted to identify the most effective components of preoperative therapy and their long-term impacts on patient outcomes. Additionally, integrating patient-specific factors into the design of preoperative protocols could optimize recovery trajectories and improve personalized care in ACL reconstruction.
    },
     year = {2025}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Evaluating Post-Surgical Recovery in ACL Repair: A Meta-Analytical Review of Preoperative Therapy Versus Non-Therapeutic Approaches
    
    AU  - Ebrahim Piri
    Y1  - 2025/05/24
    PY  - 2025
    N1  - https://doi.org/10.11648/j.ajss.20251302.13
    DO  - 10.11648/j.ajss.20251302.13
    T2  - American Journal of Sports Science
    JF  - American Journal of Sports Science
    JO  - American Journal of Sports Science
    SP  - 39
    EP  - 49
    PB  - Science Publishing Group
    SN  - 2330-8540
    UR  - https://doi.org/10.11648/j.ajss.20251302.13
    AB  - Background: Preoperative therapy has been increasingly proposed as a strategy to optimize recovery outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction. This meta-analysis aimed to evaluate the effectiveness of preoperative therapeutic interventions compared to non-therapeutic approaches in enhancing post-surgical recovery. Methods: A systematic review of the literature was conducted, and eligible studies that compared preoperative therapy with non-therapeutic approaches in ACL repair were identified. Data were extracted on various clinical outcomes, including knee mobility, overall knee function, and patient-reported quality of life. The methodological quality of the studies was rigorously assessed and a meta-analytical synthesis was performed. Findings: The results revealed that patients receiving preoperative therapy exhibited superior knee mobility and overall knee health post-surgery. However, improvements in overall knee function were similar between the two groups, suggesting that preoperative therapy may have a targeted benefit on specific functional parameters rather than a global impact. Conclusion: Preoperative therapeutic interventions appear to offer significant advantages in terms of knee mobility and overall knee health in the context of ACL reconstruction, although both preoperative and non-therapeutic approaches yield comparable results in overall knee function. These findings underscore the potential of tailored preoperative strategies to enhance targeted aspects of post-surgical recovery. Further research is warranted to identify the most effective components of preoperative therapy and their long-term impacts on patient outcomes. Additionally, integrating patient-specific factors into the design of preoperative protocols could optimize recovery trajectories and improve personalized care in ACL reconstruction.
    
    VL  - 13
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

  • Sections