Search Results (52)

Background: Idiopathic painful flexible flatfoot (FFF) in childhood can persist into adulthood, yet long-term data on subtalar arthroereisis via the calcaneo-stop (C-Stop) procedure are scarce. We aimed to evaluate clinical and functional outcomes at ≥10 years post-surgery and compare them with age-matched normative values in healthy populations. Methods: We conducted a single-time-point long-term follow-up on a subset of 232 children (age 10–14 years) selected from a retrospective cohort of 494 patients who underwent bilateral anterograde C-Stop between 2010 and 2014. Inclusion required idiopathic symptomatic FFF refractory to conservative care and a minimum 10-year follow-up. At a mean follow-up of 12.1 ± 2.5 years, patients completed the Foot and Ankle Ability Measure (FAAM) and Tegner Activity Scale (TAS). Secondary data included anthropometrics, implant details, accessory procedures, screw removal, and complications. Results: Respondents demonstrated excellent function: FAAM total 98.8 ± 3.7 (range 75–100) with 87.5% achieving the ceiling score; FAAM–ADL 99.3 ± 3.2; FAAM–Sport 98.0 ± 6.4. The mean TAS was 3.7 ± 2.0, with 53% active in sports—72% low-impact, 12% high-impact non-competitive, and 4% competitive. Sex and history of complications produced statistically significant but clinically small differences (<3% on FAAM total; <6 points on subscales). No outcome differences were observed by age or BMI, accessory procedures, or screw removal status. Conclusions: Ten years after C-Stop arthroereisis in childhood, patients exhibit functional scores comparable to normative values, high rates of ceiling effect on FAAM, and a modest level of physical activity predominantly in low-impact sports. Full article

Background/Objectives: Patellar instability in adolescents is a significant cause of short- and long-term morbidity and disability. Traditionally, patients with first-time patellar dislocation are managed nonoperatively, although most studies are not focusing on the adolescent athletic population. The primary objective of the current study was to compare patient-reported outcomes and complications in adolescent athletes who underwent surgery either after the first patellar dislocation or after the recurrence of the dislocation with a minimum postoperative follow-up of 48 months (48–75 months). Methods: A total of 39 adolescent athletes who underwent medial patellofemoral ligament (MPFL) reconstruction (Group A, after the first dislocation, and Group B, recurrent patella dislocation) were included in this study. In all the patients, the same MPFL reconstruction technique was applied using a semitendinosus autograft. The graft was fixed on the patella using a transverse tunnel and adjustable loop button fixation and, in the femur, using a tunnel and absorbable screw fixation. The tunnel was drilled obliquely to prevent penetration of the distal femoral physis. The preoperative and postoperative clinical and functional evaluations of the patients were conducted via the visual analog scale (VAS), the Lysholm Knee Scoring System, the Kujala Anterior Knee Pain Scale, and the Pediatric International Knee Documentation Committee (Pedi-IKDC), and the return to sports score was assessed via the Tegner Activity Scale (TAS). Results: At the latest follow-up, both groups demonstrated significant improvement in the Lysholm scores, with Group A achieving a mean of 92.57 ± 6.21 and Group B achieving a mean of 90.53 ± 8.21 (p = 0.062). Postoperatively, Group A achieved a mean Kujala score of 94.21 ± 9.23, whereas Group B reached 92.76 ± 12.39, with no statistically significant difference (p = 0.08). The Pedi-IKDC score improved postoperatively in both groups. In Group A, it increased from 67.98 ± 12.29 to 93.65 ± 4.1, and in Group B, from 56.21 ± 13.6 to 91.67 ± 6.21 (p = 0.067). The preoperative visual analog scale (VAS) score for pain was significantly lower in Group A (3.1 ± 1.13) than in Group B (4.2 ± 3.01, p < 0.01). At the latest follow-up, the VAS scores improved in both groups, with Group A reporting a mean score of 0.47 ± 1.01 and Group B 0.97 ± 1.32 (p = 0.083). The Tegner activity scores were similar between the groups preoperatively, with Group A at 7.72 ± 1.65 and Group B at 7.45 ± 2.09 (p = 0.076). Postoperatively, Group A had a mean score of 7.28 ± 2.15, whereas Group B had a mean score of 6.79 ± 3.70 (p = 0.065). The mean time to return to sports was significantly shorter in Group A (5.1 ± 1.3 months) than in Group B (7.6 ± 2.1 months) (p < 0.01). Overall, 84.61% of the patients returned to their previous activity level. Specifically, 95.2% (20/21) of patients in Group A achieved this outcome, whereas 72.22% (13/18) achieved it in Group B. Patient satisfaction was generally high, with 76% (16/21) of patients in Group A reporting being satisfied or very satisfied, compared with 77% (14/18) in Group B. Conclusions: MPFL reconstruction is a safe and effective procedure for both acute and recurrent patellar dislocation in adolescent athletes. While patients who underwent acute reconstruction returned to sport more quickly and showed higher absolute postoperative scores, the greatest overall improvement from preoperative to final follow-up was observed in those treated for recurrent instability. Both surgical approaches demonstrated high satisfaction rates and minimal complications, supporting MPFL reconstruction as a reliable option in both acute and recurrent cases. Full article

Background: The isolated rectus femoris tendon (RT) is a less commonly used autograft for anterior cruciate ligament (ACL) reconstruction. Graft selection is a critical part of ACL reconstruction, especially in revision surgery. Hypothesis: This study compares patient-reported outcome measurements (PROMs) between revision ACL reconstruction with an RT autograft and a hamstring tendon (HT) autograft. We hypothesized that the RT autograft will yield comparable functional results and high patient satisfaction. Study Design: This was a cohort study; the level of evidence is III. Methods: Fifty-five patients (RT n = 28; HT n = 27) who underwent revision ACL reconstruction were included in this study, with a mean follow-up time of 40.3 months (range, 16.4–64.8) for RT and 61.2 months (range, 34.6–86.3) for HT. Apart from the harvesting technique, the surgical technique was the same for both groups. Clinical and intraoperative data were collected for our postoperative registry. In addition, funcinal outcome was measured using the International Knee Documentation Committee score (IKDC), the Lysholm score, Tegner activity scale, and numeric rating scale (NRS). The type and frequency of postoperative complications were documented. Results: At the final follow-up, no significant differences were observed between the RT and HT groups in the IKDC (mean ± SD: 74.7 ± 10.9 vs. 74.9 ± 12.9), Lysholm score (90.9 ± 15.0 vs. 89.0 ± 14.6), or Tegner activity scale (median [IQR]: 5 [4–6] vs. 5 [4–6]). The mean femoral tunnel diameter was 9.0 mm (range, 7.5–10 mm) for the RT and 8.2 mm (range 7.0–9.5 mm) for the HT. The use of the RT reduced the need for a two-stage procedure by 50% compared to HT (n = 5 vs. n = 10), although this difference was not statistically significant (p = 0.11). Stability measured by the Lachman test improved significantly in both groups from the pre- to postoperative period. Retear of the ACL graft was observed in two patients in both groups (7.1% RT and 7.4% HT). Conclusions: The RT and HT autografts achieved similar outcomes in PROMs for revision ACL reconstruction. Good tendon quality with parallel fibers and adjustable thickness characterize the RT. A tendency for a reduced rate of two-stage surgery with RT was noticed. Clinical Relevance: The incidence of revision ACL reconstruction is rising. Surgeons should be aware of all the available graft options. The isolated RT expands the range of autografts available for ACL reconstruction. Full article

This study aimed to analyze the biomechanical differences in knees that underwent reconstruction using four-strand hamstring or bone–patellar tendon–bone autografts during the side-hop test. This case–control study included 46 participants: 18 controls, and 28 individuals who underwent reconstruction with hamstring (n = 15) or patellar (n = 13) tendons. The Theia Markerless system and Visual3D provided information on knee kinematics, namely time of contact with the ground, maximum varus and valgus angles, and flexion during maximum valgus and varus. Additionally, we assessed the activity levels of the participants pre- and post-surgery using the Tegner Activity Scale. Data analysis was conducted using ANOVA and Tukey’s post hoc test. Significant differences were observed in terms of contact time with the ground between the control and autograft groups (p = 0.025, g = −1.13; p = 0.014, g = −1.09), but not between the autograft groups. Other variables did not demonstrate statistically significant differences; however, there was a slight tendency to greater valgus in patellar autografts and greater varus with hamstring tendons. The absence of significant differences between the groups may indicate that both autografts allow knee kinematics restoration by engaging neuromuscular and proprioceptive mechanisms that compensate for anatomical alterations. Full article

Background/Objectives: The treatment of cartilage damage is an ongoing challenge. Several techniques have been developed to address this problem. Matrix-Induced Autologous Chondrocyte Implantation (MACI) is often referred to as the “gold standard” for cartilage treatment. Numerous long-term outcome studies also have reported favorable results with Autologous Matrix-Induced Chondrogenesis (AMIC). Minced Cartilage Implantation (MCI) is a recently developed arthroscopic method. This technique has demonstrated promising outcomes, with the prospect of longer-term results still under investigation. This study aims to directly compare the patient-reported outcomes of these three techniques over a 2-year follow-up period. Methods: A total of N = 48 patients were included in the retrospective matched pair analysis (n = 16 MACI, n = 16 AMIC, n = 16 MCI). VAS, KOOS-Pain, and KOOS-Symptoms scores served as primary outcomes; the KOOS-ADL and -QOL and the Tegner Activity Scale (TAS) served as secondary outcomes. Results: All three groups did not differ from each other in the primary or secondary outcomes. Pain and function significantly improved from pre-surgery to two years after (VAS: p < 0.000; ES: η² = 0.27; KOOS-Pain: p < 0.000; ES: η² = 0.30; KOOS-Symptoms: p = 0.000; ES: η² = 0.26; KOOS-ADL: p > 0.000; ES: η² = 0.20; KOOS-QOL: p > 0.000; ES: η² = 0.30). There was no significant effect of time on the activity level. Conclusions: All three procedures show good patient-reported outcomes, low complication rates, and long graft longevity in the 2-year follow-up. Therefore, all three methods seem to be equally recommendable for the treatment of cartilage lesions. Full article

This study explores the effectiveness of the Movement System Impairment (MSI) model compared to traditional physiotherapy for treating knee pain. Fifty patients with unilateral knee pain participated, with their femur, tibia, and knee alignment assessed in nine functional positions. Evaluations included the Tegner Activity Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), muscle power, extensibility, and pain levels. Patients were randomly assigned to either the MSI treatment group, which focused on identifying and correcting faulty movements, or a routine physiotherapy group that received general strengthening and stretching exercises. Results indicated that both treatment approaches improved muscle power in hip abductors and lateral rotators, as well as scores on the Tegner Activity Scale and the KOOS. Notably, the MSI group demonstrated greater improvements in the muscle power of the hip lateral rotators and knee extensors and a significant reduction in knee pain during walking compared to the routine group (p = 0.005). In conclusion, both treatments enhanced pain, function, and muscle strength, while the MSI model significantly reduced knee pain in walking and improved hip and knee muscle power compared to routine physiotherapy. Full article

Background: Tendon lesions affecting the proximal rectus femoris (PRF) muscle represent about 1.5% of hip injuries. Most acute cases are managed conservatively with physiotherapy. There is a lack of consensus regarding surgical intervention for chronic injuries. This article, alongside a literature review, presents a case of anatomical surgical reinsertion for chronic complete avulsion rupture of the PRF tendon. Case Report: A 34-year-old amateur athlete experienced acute inguinal pain from overexertion, with conservative treatment having failed over 3 months. Seven months later, proximal tendon rupture involving both PRF muscle heads was confirmed. An anterior Hueter approach released the tendon from the adhesions and fibrosis. The direct portion was reinserted into the inferior anterior iliac spine, and the reflex portion was reattached to the supraacetabular groove. The patient showed excellent improvement on the modified Harris Hip and Lysholm–Tegner scales. The quadriceps muscle force decreased by 20% compared to the contralateral leg at 3 months, reducing to 4% by 12 months. Normal activities resumed after six weeks, and sports resumed after 4 months. Conclusions: The patient experienced significant postoperative improvement, as shown by the enhanced functional scores and muscle force recovery over one year. The success of the anatomical reconstruction in restoring tendon continuity underscores the importance of tendon healing mechanisms, including tissue remodeling and revascularization, in chronic avulsion injuries. This case highlights the efficacy of anatomical reconstruction for chronic PRF tendon avulsion. The literature review offers further insights into treatment options and the physiological basis of recovery for such injuries. Full article

Background/Objectives: Lateral extraarticular tenodesis (LET) has been advocated in revision anterior cruciate ligament reconstruction (ACLR) to improve knee stability and furthermore, decrease failure rates. The aim of this study was to compare clinical outcomes, knee laxity, and failure rates after revision ACLR with LET (ACLR + LET) versus without LET. It was hypothesized that ACLR + LET improves clinical outcomes and reduces the failure rate. Methods: A retrospective analysis of prospectively collected data was conducted to examine patients who underwent revision ACLR with and without LET between 2017 and 2021 with a minimum follow-up of 24 months. Patients with coronal malalignment (>5°), posterior tibial slope >12°, and concomitant injuries to collateral ligaments were excluded. Patient reported outcome measures (PROMs) included the International Knee Documentation Committee (IKDC) subjective knee score, the Lysholm score, and the Tegner activity scale (TAS). Anterior knee laxity was measured with a Rolimeter and side-to-side difference (SSD) was determined. Revision ACLR failure was defined as ACL revision surgery and SSD > 5 mm. Group comparisons were performed using chi-square-, independent-samples students t-test or Mann–Whitney–U tests. Results: Of 56 eligible patients, 45 (80%, follow up, 23 isolated rACLR vs. 22 rACLR + LET) were included with a mean follow-up of 45.6 ± 15.8 months. Postoperative PROMs were not statistically different between rACLR and rACLR + LET groups (IKDC: 73.0 ± 18.9 vs. 68.7 ± 16.6, n.s.; Lysholm: 84.8 ± 12.3 vs. 77.7 ± 16.2, n.s.). Both groups showed similar TAS (rACLR vs. rACLR +LET (5; range 4–6 vs. 4; range 3–5; n.s.). Anterior knee laxity SSD was 2.4 ± 1.3 mm in the rACLR group and 1.8 ± 1.8 mm in the rACLR + LET group (n.s.). The failure rate was 13% in the rACLR group compared to 4.5% in the rACLR + LET group (n.s.). Conclusions: Isolated revision ACLR showed comparable postoperative patient-reported outcome measures and anterior knee laxity compared to ACLR + LET at mid-term follow up. The addition of a LET demonstrated a lower, though non-significant, failure rate after revision surgery. However, future studies with a prospective, randomized design and an increased number of patients are needed to clearly identify the exact indication for the use of additional LET. Full article

Background/Objectives: An early accelerated rehabilitation is generally recommended after surgery for acute Achilles tendon ruptures (ATRs). The modified side-locking loop suture (MSLLS) is a surgical technique that provides high tensile strength to the repaired Achilles tendon and allows for a safe, early accelerated rehabilitation protocol without requiring postoperative immobilization. However, there are no reports investigating the clinical outcomes of the MSLLS technique with early accelerated rehabilitation for ATRs. To clarify the effectiveness of the MSLLS technique with an early accelerated rehabilitation protocol for ATR in athletes. Methods: We retrospectively analyzed 27 athletes (Tegner activity score ≥ 6) who underwent surgical treatment using the MSLLS technique for ATR between April 2017 and August 2022. All patients underwent an early accelerated rehabilitation protocol without immobilization. Outcome measures included the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) score taken preoperatively and one year postoperatively, the time required to perform 20 continuous double-leg heel raises (DHR) and single-leg heel raises (SHR), the time to return to the original sport, and the presence of any complications. Results: The mean AOFAS score significantly improved from 37.2 ± 9.7 preoperatively to 96.3 ± 5.3 one year postoperatively. The mean time to be able to perform 20 continuous DHR and SHR was 7.7 ± 1.2 weeks and 11.3 ± 1.6 weeks, respectively. All patients were able to return to their original sport at their pre-injury level in an average of 22.7 ± 3.7 weeks without complication. Conclusions: The MSLLS technique in conjunction with an early accelerated rehabilitation protocol for ATR in athletes produced satisfactory results, with all patients able to return to their original sport at their preinjury level without complication. Full article

Background: Anterior cruciate ligament reconstruction (ACLR) using double adjustable fixation gained popularity in the last decade due to its minimally invasive technique. However, suspensory fixation devices could be related to recurrent instability, poor clinical outcomes, and patient dissatisfaction. The present study aims to evaluate the clinical outcomes following ACLR using double adjustable-loop suspensory fixation devices in the demanding population of young patients. Methods: Between 2019 and 2022, 95 patients with knee post-traumatic anterior cruciate ligament insufficiency were treated with primary ACLR using semitendinosus quadrupled graft and double adjustable-loop suspensory fixation devices and followed for at least two years. Concomitant lesions were also treated at the same surgical time. The knee examination form of the International Knee Documentation Committee (IKDC) was used to assess clinical evaluation, and the return to physical activities using the Tegner Activity Scale was recorded. Patient-reported objective measures (PROMs) were also evaluated, including the IKDC subjective and Lysholm scores. Results: Sixty-six males and twenty-nine females with a mean age of 23.8 (range 18–37) and a mean BMI of 24.9 (SD ± 2.42) kg/m² were included in this study. All patients were evaluated clinically as normal or nearly normal at the final follow-up. PROMs also significantly improved postoperatively (p < 0.05) compared to the preoperative values. The Tegner Activity Scale increased from 2 to 7, the IKDC mean score improved from 43.9 (±8.9) to 93.3 (±12.3), and the modified Lysholm from 47.3 (±11.1) to 92.9 (±16.6). No complications or adverse events were recorded. Conclusions: Anterior cruciate ligament reconstruction utilizing double adjustable-loop suspensory fixation devices provides good clinical and functional outcomes in young patients at a two-year follow-up. Full article

Background/Objectives: Evaluations allowing patients to return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) should be multimodal, including a psychological evaluation. The goal of this study was to determine if there is a correlation between the ACL–return to sport after injury (ACL-RSI) score at 6 months post-ACLR and mid-term functional results. Methods: A total of 498 patients were assessed 6 months after primary ACLR using a composite test including isokinetics, hops, and ACL-RSI. A minimum of 3 years of follow-up was necessary. At the last follow-up, each patient completed clinical and functional evaluations, including the subjective International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, Self Knee Value (SKV), and ACL-RSI score. The results were compared overall and item by item. Results: At the last follow-up, the mean SKV, Tegner, IKDC, and ACL-RSI scores were 86.8 ± 14.3%, 6 ± 2.1, 77 ± 11.9%, and 68.8 ± 25.7%, respectively. A significant correlation existed between the 6-month ACL-RSI score and each functional test (respectively, ρ = 0.189 p < 0.001; ρ = 0.174 p < 0.001; ρ = 0.237 p < 0.001). The ACL-RSI score was significantly higher than at 6 months after surgery (p < 0.001). Over half (59.2%) of the cohort returned to an equal or greater level of activity, and there was a significant correlation between the 6-month ACL-RSI score and post-surgery level of activity. Conclusions: Patients with better ACL-RSI scores at 6 months post-ACLR have better functional results in the medium term and are more likely to RTS. Our results show a correlation between psychological factors at 6 months, measured through the ACL-RSI score, and activity level at mid-term follow-up. This study underlines the relationship between RTS and psychological effects, and the importance of ACLR rehabilitation to focus on decreasing apprehension and fear. Full article

Background: Osgood–Schlatter disease (OSD) occurs mainly in physically active adolescents, causing significant physical activity restrictions. The aim of this study is to compare the effectiveness of treating OSD with leukocyte-rich platelet-rich plasma (LR-PRP) depending on the duration of the disease and to attempt to develop an alternative treatment method to the currently used conservative therapy. Methods: Treatment efficacy was evaluated using the VAS, Tegner, Lysholm, and KOOS scales. Subject satisfaction, return to sports activity, potential adverse effects, and X-ray evaluation were likewise used to assess the success of the procedure. Results: Analysis across all scales showed statistically significant treatment effectiveness with LR-PRP in both groups of patients. When comparing the two groups, significantly better treatment outcomes were achieved in the acute phase of OSD. Treatment satisfaction in the acute OSD group was 95%, compared to 64% in the chronic group. The MCID value after LR-PRP injection in acute OSD compared to chronic OSD reached 100% vs. 81% on the VAS scale, 95.5% vs. 55% on the Tegner scale, 95% vs. 47% on the Lysholm scale and 91% vs. 27% on the KOOS scale. No adverse effects were recorded in either group. Conclusions: The high efficacy of LR-PRP treatment in patients with acute OSD, in correlation with high safety, as well as rapid and lasting results, can be an effective and beneficial alternative to conservative treatment. This single procedure seems particularly justified in a group of young professional athletes, where absence from training can lead to serious consequences. Full article

Background: Patellar tendinopathy (PT) involves anterior knee pain and functional. Platelet-rich fibrin matrix (PRFM) is a promising biological therapy for tendinopathies. We examined a cohort of PT patients treated with tendon debridement and autologous PRFM at the 24-month follow-up to assess whether the combined treatment facilitated return to sports and yielded satisfactory clinical and functional scores. Methods: Baseline and 24-month visual analogue scale (VAS), Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P), Tegner Activity Scale (TAS), and Blazina scores were compared to evaluate treatment effectiveness. The Friedman test was used to compare repeated observations of VAS, VISA-P, TAS, and Blazina Score values. Return to sport rate, Tampa Scale of Kinesiophobia (TKS) score and patient satisfaction were collected at 24 months. Results: The postoperative clinical scores demonstrated significant improvement compared with their preoperative values (all p < 0.001). Specifically, the VISA-P score was 80.32 (±20.58), 92.10% of patients had resumed sports activities and patient satisfaction was 9.21 (±1.21) at 24 months. Conclusions: Surgical debridement and autologous PRFM application in patients with chronic PT resulted in a higher rate of return to sports when compared to solely surgical treatment, significantly improved clinical outcomes and excellent patient satisfaction at 24 months. Full article

Background: Patients with complex proximal tibial plateau fractures (TPFs) tend to overestimate the prognosis of their injury, potentially due to factors such as a limited understanding, optimism, and the influence of the pain intensity. Understanding the reasons behind this misperception is crucial for healthcare providers to effectively communicate with patients and establish realistic expectations for treatment outcomes. The purpose of this study was to analyze the outcomes of TPFs, with a particular focus on patient-reported outcome measures concerning functional recovery, pain levels, and overall satisfaction with treatment. The authors aim to provide valuable insights into the realistic expectations and potential limitations that patients may encounter during their recovery journey. Methods: In this retrospective single-center study, all surgically treated TPFs between January 2014 and December 2019 with a minimum follow-up of 12 months were included. Several patient-reported outcome measures were obtained, including the International Knee documentation Committee Score (IKDC), Lyholm score, Tegner score, and visual analog scale (VAS) for pain. Fractures were classified according to Schatzker, and then subgrouped into simple (Schatzker I–III) and complex (Schatzker IV–VI) fractures. Results: A total of 54 patients (mean age 51.1 ± 11.9 years, 59.3% female) with a mean follow-up time of 3.9 years were included. Schatzker II fractures were present in 48% (n = 26) of the cases, with Schatzker III in 6% (n = 3), Schatzker IV fractures in 6% (n = 3), and Schatker VI fractures in 41% (n = 22) of the cases. All outcome scores showed a significant improvement between the first year after surgery and the last follow-up (mean: 3.9 years). Simple fractures showed significantly lower patient-reported outcomes when compared to the preinjury state; however, good to excellent results were observed. Patient-reported outcomes of complex fractures showed no significant changes in the study period with good to excellent results. When it comes to the Lysholm score, there were no significant differences in the outcome between simple and complex fractures. Furthermore, there was a return-to-sports rate of 100%, with high rates of changing sporting activity in 25% (simple fractures) and 45% in complex fractures. Conclusions: The data from this study showed that both simple and complex tibial plateau fractures show favorable outcomes at the midterm follow-up, and that injury severity does not correlate with worse results. While patients may tend to overestimate the recovery speed, this research highlights the importance of long-term follow-up, demonstrating a substantial improvement between one year post-surgery and the final evaluation. Return-to-sports rates were high, with adjustments needed for certain activities. However, patients should recognize the need to shift to lower-impact sports and the lengthy recovery process. Full article

Background: After the increasingly common anterior cruciate ligament reconstruction (ACLR) procedure in competitive athletes, rehabilitation is crucial for facilitating a timely return to sports (RTS) and preventing re-injury. This pilot study investigates the patient-reported outcomes of postoperative rehabilitation in competitive athletes, comparing supervised rehabilitation (SVR) and home-based rehabilitation (HBR). Methods: After ACLR, 60 (out of 74 screened) athletes were recruited and equally divided into HBR and SVR groups using non-probability convenience sampling, with each group comprising 15 males and 15 females. The rehabilitation outcomes in the respective groups were evaluated at 8 months using measures (Tegner Activity Scale [TAS], International Knee Documentation Committee subjective knee form [IKDC-SKF], ACL Return to Sport after Injury [ACL-RSI]) and objective parameters (isometric muscle strength, hamstring/quadricep asymmetry). RTS was evaluated at 9 months, with ACL re-injury rates recorded approximately 6 months post-RTS. Results: Both groups exhibited decreased TAS scores (HBR: 8 to 6, SVR: 8 to 7), with the SVR group demonstrating superior postoperative IKDC-SKF scores (81.82 vs. 68.43) and lower ACL-RSI scores (49.46 vs. 55.25). Isometric and isokinetic muscle strength, along with asymmetry values, was higher in the SVR group 8 months post-ACLR (p < 0.05). The SVR group showed a higher RTS rate to the same level (76.6% vs. 53.3%), while the re-injury rate was the same in both the rehabilitation groups (3.3%). Conclusions: Although both rehabilitation approaches yielded comparable outcomes, SVR may demonstrate some superior biomechanical improvements in athletes, resulting in a higher RTS rate. However, the psychological outcomes and re-injury rates did not significantly differ between the groups, emphasizing the need to address individual psychological needs during rehabilitation. Further investigation is recommended with a larger sample size to address the differences of gender among competitive athletes. Full article