Functional Outcomes After Anterior Cruciate Ligament Reconstruction: Lysholm Score Analysis: Lysholm Scores After ACL Reconstruction

Aytekin Dikici; Sezai Özkan; Şehmuz  Kaya; Cihan  Adanaş; Necip  Güven; Tülin Türközü; Adnan  Arslan; Bayram  Ersidar; Yunus Can Ünal

doi:10.28982/josam.8600

Authors

Aytekin Dikici Van Regional Training and Research Hospital, Department of Orthopedics and Traumatology, Van https://orcid.org/0000-0002-2797-3326
Sezai Özkan Department of Orthopedics and Traumatology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye https://orcid.org/0000-0003-4444-6939
Şehmuz Kaya Department of Orthopedics and Traumatology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye https://orcid.org/0000-0002-9636-5260
Cihan Adanaş Department of Orthopedics and Traumatology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye https://orcid.org/0000-0002-3652-6077
Necip Güven Department of Orthopedics and Traumatology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye https://orcid.org/0000-0002-0363-1524
Tülin Türközü Department of Orthopedics and Traumatology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Türkiye https://orcid.org/0000-0002-0966-9080
Adnan Arslan Van Regional Training and Research Hospital, Department of Orthopedics and Traumatology, Van https://orcid.org/0009-0006-3119-6239
Bayram Ersidar Van Regional Training and Research Hospital, Department of Orthopedics and Traumatology, Van https://orcid.org/0000-0001-9115-5857
Yunus Can Ünal Van Regional Training and Research Hospital, Department of Orthopedics and Traumatology, Van, Türkiye https://orcid.org/0009-0001-6733-4211

DOI:

https://doi.org/10.28982/josam.8600

Keywords:

Anterior Cruciate ligament, Lysholm Score, Hamstring Tendon Graft., rehabilitation, physical therapy

Abstract

Background/Aim: Anterior cruciate ligament reconstruction is followed by a prolonged rehabilitation period, and the relative effectiveness of supervised clinical physical therapy versus a structured home exercise program remains clinically relevant. This study evaluated postoperative functional recovery using the Lysholm knee scoring system after arthroscopic anterior cruciate ligament reconstruction with autologous hamstring grafts and compared outcomes between patients who received supervised clinical physical therapy and those who followed an independent home exercise program.

Methods: In this prospective cohort study conducted from May 2019 through May 2021, 28 male patients with complete anterior cruciate ligament tears underwent arthroscopic single-bundle reconstruction using hamstring autografts, with femoral Endobutton fixation and tibial bioabsorbable interference screw fixation. Mean age was 33.03 (8.53) years (range, 18-56 years). Group 1 (n = 7) received supervised clinical physical therapy three times weekly for 12 weeks, whereas Group 2 (n = 21) followed a structured home exercise program. Lysholm scores were assessed preoperatively and at 3 and 6 months. Between-group comparisons were exploratory and used two-sided Welch t-tests calculated from reported summary statistics. Longitudinal changes were described without inferential testing.

Results: Preoperative Lysholm scores were 72.57 (10.21) in Group 1 and 70.95 (11.45) in Group 2 (P = 0.731). Mean scores increased over time in both groups. At 3 months, scores were 92.86 (5.14) and 83.71 (8.92), respectively (P = 0.004); at 6 months, they were 98.17 (2.36) and 89.76 (7.41), respectively (P < 0.001). The between-group comparison of change from baseline to 6 months was not statistically significant (P = 0.145). These P-values are unadjusted exploratory comparisons calculated from rounded summary statistics. Medial meniscal tears were present in 11 patients (39.3%).

Conclusion: Arthroscopic anterior cruciate ligament reconstruction with autologous hamstring grafts was associated with higher mean Lysholm scores at follow-up. The supervised physical therapy group had higher 6-month scores, but the between-group difference in baseline-to-6-month change was not statistically significant in exploratory unadjusted comparisons. Small, unequal, nonrandomized groups limit causal interpretation.

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