Annals of Internal Medicine · IF 19.9 · September 28, 2026 · LoE I
Exercise Therapy and Education for Young Adults With Persistent Knee Problems After Anterior Cruciate Ligament Reconstruction
Adam Geoffrey Culvenor, Andrea Maree Bruder, T. West, Christian J. Barton, Ewa Maria Roos, Edwin H. Oei, Steven McPhail, Richard B. Souza, Jusuk Lee, Brooke Patterson, M. Girdwood, Jamon L. Couch — La Trobe University
This randomized trial enrolled 184 young adults (92 per group) who still had knee problems about two years after ACL reconstruction. It compared a supervised, physiotherapist-led exercise and education program (SUPER: about 4 months of twice-weekly sessions, then home exercise with booster visits) against a single education session plus a self-directed exercise booklet. The material supplied was only the supplement. It shows only raw group means, not the between-group estimate. The primary score was KOOS4 (a 0 to 100 knee symptom and function score, higher is better). At 4 months it averaged 78.8 with SUPER versus 73.2 with control; at 12 months it was 80.6 versus 78.1, from similar baselines (64.7 vs 63.7).
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersMany patients still have pain and poor knee function years after ACL reconstruction, and this trial tests whether a structured late-stage exercise program can help them.
Conclusion strengthInconclusive
How many patients this affects and needs no new equipment or resource.
Presenting this at rounds? Start here
- ?For a patient who still has symptoms two years after ACL reconstruction, when would you refer them for a supervised exercise program rather than handing them a home exercise resource?
- ?If the advantage of supervised exercise narrows between 4 and 12 months, how would you counsel patients about keeping up their exercise after formal physiotherapy ends?