Home-based rehabilitation following anterior cruciate ligament reconstruction in the Kurdistan region of Iraq: epidemiology and outcomes

Nardeen Kader*, Samantha Jones, Ziyad Serdar, Paul Banaszkiewicz, Deiary Kader

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose
This study, set in in the Kurdistan region of Iraq, describes the epidemiology and outcomes of anterior cruciate ligament reconstruction (ACLR) followed by home-based rehabilitation alone.

Methods
A cohort observational study of patients aged ≥ 16 years with an ACL rupture who underwent an ACLR under a single surgeon. Followed by a home-based rehabilitation programme of appropriate simplicity for completion in the home setting; consisting of stretching, range of motion and strengthening exercises. Demographics, mechanism of injury, operative findings, and outcome data (Lysholm, Tegner Activity Scale (TAS), and revision rates) were collected from 2016 to 2021. Data were analysed using descriptive statistics.

Results
The cohort consisted of 545 patients (547 knees), 99.6% were male with a mean age of 27.8 years (SD 6.18 years). The mean time from diagnosis to surgery was 40.6 months (SD 40.3). Despite data attrition Lysholm scores improved over the 15-month follow-up period, matched data showed the most improvement occurred within the first 2 months post-operatively. Post-operative TAS results showed an improvement in level of function, but did not reach pre-injury levels by final follow-up. At final follow-up, six (1.1%) patients required an ACLR revision.

Conclusion
Patients who completed a home-based rehabilitation programme in Kurdistan had low revision rates and improved Lysholm scores 15 months post-operatively. To optimise resources, further research should investigate the efficacy of home-based rehabilitation for trauma and elective surgery in low- to middle-income countries and the developed world.
Original languageEnglish
Pages (from-to)481-488
Number of pages8
JournalEuropean Journal of Orthopaedic Surgery and Traumatology
Volume33
Issue number3
Early online date29 Nov 2022
DOIs
Publication statusPublished - 1 Apr 2023
Externally publishedYes

Keywords

  • Anterior cruciate ligament reconstruction rehabilitation
  • Orthopaedic surgery
  • Anterior cruciate ligament reconstruction
  • Home-based physiotherapy
  • Home-based rehabilitation
  • Self-directed rehabilitation

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