Supervised physical therapy improves short-term knee pain and function after ACL surgery in young adults

by American College of Physicians

edited by Sadie Harley, reviewed by Andrew Zinin

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A randomized clinical trial found that supervised physical therapy after anterior cruciate ligament (ACL) surgery yielded greater improvements in pain, function and muscle strength than a self-directed exercise program, at least in the short term. The findings can inform care for people with ongoing knee symptoms after ACL surgery. The study is published in Annals of Internal Medicine.

Researchers from the La Trobe Sport and Exercise Medicine Research Center at La Trobe University and colleagues randomly assigned 184 adults ages 18 to 40 who continued to have knee problems nine to 36 months after ACL reconstruction to either a supervised exercise and education program or a one-time education session with self-directed exercise resources.

The primary outcome was the change at four months in the composite Knee injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes included the change in KOOS at 12 months, thigh muscle strength and cartilage thickness.

After four months, participants in the supervised program reported greater improvements in knee symptoms and quality of life, stronger thigh muscles and higher rates of perceived recovery. However, by 12 months, the gap between groups had narrowed, and there were no differences in cartilage thickness.

The researchers conclude that supervised exercise therapy combined with education offers meaningful short-term benefits for young adults with ongoing knee problems after ACL reconstruction and provides evidence that exercise is not harmful to knee joint cartilage.

Publication details

Exercise Therapy and Education for Young Adults With Persistent Knee Problems After Anterior Cruciate Ligament Reconstruction: A Randomized Clinical Trial, Annals of Internal Medicine (2026). DOI: 10.7326/ANNALS-26-02460

Journal information: Annals of Internal Medicine

Key medical concepts

Anterior Cruciate Ligament ReconstructionKnee Injury and Osteoarthritis Outcome Score

Clinical categories

Allied healthSports medicineOrthopedicsFitness & Physical activity Provided by American College of Physicians Who's behind this story?

Sadie Harley

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