Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire

Sebastian Zduński, Witold Rongies, Marcin Ziółkowski, Tomasz Kozieł, Janusz Sierdziński

S. Zduński, W. Rongies, M. Ziółkowski, T. Kozieł, J. Sierdziński – Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire. FP 2017; 17(2); 60-70

Abstract

Introduction. In recent years, there has been an increase in the number of knee injuries with subsequent total anteriur ligament injury (ACL). ACL lesions in most cases require specialized surgical and physiotherapeutic treatment. The main goal of rehabilitation is to restore the full function of the knee joint and the entire lower limb. Interest in methods of assessing the outcome of ACL reconstruction procedures has increased recently. A number of questionnaires and scales were developed to assess the outcome of treatment. An example is the Knee and Osteoarthrosis Outcome Score (KOOS).
The aim of the study. Assessment of near and distant outcomes of post-arthroscopic anterior cruciate ligament reconstruction in the selected model of Knee and Osteoarthrosis Outcome Score (KOOS).
Material and methodology. Randomized study included 72 patients with a complete rupture of the ACL identified for operative reconstruction. The study group included 37 patients aged 18 to 60 years (mean 37 ±10.3 years). All subjects in this group were subjected to a physiotherapy for 4 weeks prior to reconstructive surgery. In total, 10 to 12 therapeutic sessions were conducted. The control group included 35 patients aged 18 to 60 years (mean 34 ±10.0 years) who did not perform the preoperative physiotherapy program. The postoperative physiotherapy program was the same in all subjects studied.
Results. There was a statistically significant improvement in the functional assessment of the knee joint after reconstruction of the ACL using the KOOS questionnaire in the Study and Control groups at subsequent measurement points (p < 0.05). Better results in the Study Group were found in almost all subgroups of KOOS (symptoms, stiffness, daily activities, activity, quality of life) 6 and 12 weeks after ACL reconstruction. However, there was no statistically significant difference between the Study and Controlled Group (p > 0.05). There was a statistically significant difference in the “stiffness” of the KOOS scale after 12 weeks (p < 0.05). There was also a statistically significant difference in the SP3 (skipping ability) of the KOOS scale after 12 weeks (p < 0.05).
Conclusions. 1. Obtained results in both examined groups, in terms of functional capabilities evaluated by the KOOS questionnaire after reconstruction, confirm the good quality of performed surgical procedures and physiotherapeutic activities.  2. A better KOOS score in the Study Group indicates the high therapeutic value of preoperative rehabilitation.

Key words:
anteriur cruciate ligament, knee joint, physiotherapy, KOOS questionnaire

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