Published Rehabilitation Programs for Patients With Anterior Cruciate Ligament Reconstruction Are Poorly Reported and Not Reproducible in Clinical Practice: A Scoping Review

OBJECTIVE: To evaluate the clinical reproducibility of published rehabilitation programs for patients with anterior cruciate ligament reconstruction (ACLR). DESIGN: Scoping review. LITERATURE SEARCH: The PubMed, Web of Science, Cochrane Library, and Scopus databases were searched on July 8, 2024 from inception to the latest record. STUDY SELECTION CRITERIA: We included randomized and non-randomized intervention studies (prospective and retrospective) that were published in English language and that included a minimum 20 patients with ACLR. DATA SYNTHESIS: Domains to categorize rehabilitation were developed and evaluated for clinical reproducibility using the Template for Intervention Description and Replication (TIDieR) checklist. RESULTS: 296 studies were included, 185 of which were randomized controlled trials (63%). The total participants included were 22564. To describe rehabilitation programs, 28 domains emerged. None of the studies included all the identified domains. Forty-three studies (15%) included 1 domain, and 1 study reported on 21 domains. Three-quarters of the studies (78%) reported on whether the implemented interventions were time- (87.5% of them) or criteria-based (12.5%). There was substantial heterogeneity in the thoroughness of reporting rehabilitation programs. Most studies did not describe fundamental details of the rehabilitation interventions and associated progression parameters. All studies lacked sufficient detail to enable clinical reproducibility. CONCLUSION: Published rehabilitation programs for patients with ACLR lacked sufficient detail to enable clinicians to reproduce the programs in practice. Greater reporting consistency is needed on all aspects of rehabilitation, including program structure, specific intervention details, progression criteria, and return to sport decision-making.