Functional Outcome of ACL Reconstruction Following Pre-reconstruction Rehabilitation vs. None Rehabilitation: A Systematic Review and Meta-analysis.

 The aim of this study is to analyse the needs for pre-operative rehabilitation in patients undergoing ACL reconstruction.  The database reports were searched within 2018 to 2023, using PubMed, Cochrane library database, Medline, and other published trials. A statistical analysis was made from Review Manager.  Pre-operative rehabilitation group shows significantly higher 2 years post-operative KOOS score in all subscore and the total mean of the score, pain (p < 0. 0001), symptoms (p < 0. 0001), ADL (p < 0. 0001), sports and recreations (p < 0. 0001), QoL (p < 0. 0001), and the total mean of the KOOS score (p < 0.0001). In contrary, pre-operative rehabilitation group shows insignificantly higher score on 3 months post-operative Lysholm score (p = 0.12).  This meta-analysis conclude pre-operative rehabilitation may provide better long-term post-operative outcome, however it may not provide much of a short-term outcome. It is recommended to add pre-operative rehabilitation as a guideline for ACL injury management to improve long-term outcome of patients with ACL injury undergoing ACL reconstruction procedure.