Using a self-rehabilitation application alone can effectively combat post-ACL ligament reconstruction flexion contracture during the COVID-19 lockdown

Objectives: The lockdown during the COVID-19 crisis deprived the majority of patients who had undergone ACL surgery of access to their physical therapist. The objective of the study was to analyze the benefit of using a self-rehabilitation application to combat post-ligament reconstruction flexion contracture in the absence of rehabilitation during the lockdown.Methods: We conducted a retrospective study that compared 2 groups of patients who had undergone ACL reconstruction: the "App" group that underwent surgery between 10 February and 15 March 2020 were partially or totally deprived of access to a physiotherapist due to the COVID-19 lockdown and had completed rehabilitation using a self-rehabilitation application, and the "Physio" group that underwent surgery between 16 May and 23 December 2019 and had completed rehabilitation with a physiotherapist.Results: 148 patients were included in the study: 47 in the "App" group and 101 in the "Physio" group. Mean flexion contracture 3 weeks postoperatively was 1.3° +/- 3.8 in the "App" group versus 3.3° +/- 4 in the "Physio" group (p=0.002). The rate of flexion contractures was 45% in the “App” group and 65% in the “Physio” group (p=0.025). 71.4% of the patients acquired knee locking on weight-bearing with crutches in the "App" group, compared to 40.6% in the "Physio" group (p<0.01). No significant difference was noted between the two groups concerning the degree and rate of flexion contractures 6 weeks postoperatively and quadriceps recovery at 3 and 6 weeks postoperatively.Conclusion: Our study showed that the use of a self-rehabilitation application that targets flexion contracture control and quadriceps recovery in the first 6 weeks after ACL reconstruction provides similar results to a rehabilitation protocol by an independent physiotherapist.