DOS 2020
198 · DOS Abstracts Surgical conversion rate and patient-reported outcome after treatment with a physiotherapy-led progressive exercise program plus a PCL support brace in patients with an acute injury of the posterior cruciate ligament Randi Gram Rasmussen, Julie Sandell Jacobsen, Birgitte Blaabjerg, Lene L. Miller, Martin Lind Department of Physioterapy and Occupational Therapy, Aarhus University Hospital; Research Centre for Health and Welfare Technology and Department of Physiotherapy, VIA University College, Aarhus; Department of Orthopaedic Surgery, Aarhus University Hospital Background: PCL injuries can be treated surgically or with progressive exercises in com- bination with a PCL support brace. However, larger prospective studies reporting out- come of exercise-related treatment are lacking. Purpose / Aim of Study: We aimed to investigate changes in patient-reported and functional outcome of a physiotherapy-led progressive exercise program plus a PCL sup- port brace in patients with an acute injury of the PCL over a 24- months follow-up. Furthermore, to report conversion to surgical reconstruction. Materials and Methods: In a prospective case-series study, 50 patients were treated with a PCL support brace for 12 weeks and underwent a 16-week physiotherapy- led progressive exercise program. Changes in patient-reported outcome was investigated with the International Knee Documentation Committee Subjective Knee Form (IKDC- SKF) from baseline to 1 and 2 years. Furthermore changes in isometric knee flexion and extension strength was measured from 16 weeks to 1 year. Mean changes were analyzed with a mixed effect model with patients as a random factor and time as a fixed factor. Findings / Results: Seven patients converted to PCL reconstruction and one patient dropped out resulting in 42 patients for 1-year follow-up that completed the combined brace and rehabilitation treatment. Of the patients converting to reconstruction, two patients had an isolated ligament injury and five patients had dislocation of the knee. The IKDC-SKF score at baseline was 35 (SD 9.7) and at 2 years 62 (SD 15). Isometric knee flexion strength of the injured knee increased statistically significantly from 0.93 (SD 0.36) Nm/kg to 1.1 (SD 0.36) Nm/kg, corresponding to an increase of 17%. In contrary isometric knee extension strength of the injured knee did not change (0.10 (-0.022- 0.21) Nm/kg, p=0.107). Conclusions: Treatment resulted in a 14% conversion rate to surgical treatment. The treatment demonstrated clinically relevant improvements in patient- reported outcome and an improvement of 17% in flexor strength. Consequently, limited need for conver- sion to surgical treatment, clinically relevant improvements in subjective outcome and strength after PCL support brace treatment and a progressive exercise program can be expected in patients with an acute PCL injury. 177.
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