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To achieve the unachievable—Patients' experiences of opting for delayed anterior cruciate ligament reconstruction after trying rehabilitation alone as primary treatment: A qualitative study
Sportrehab, Gothenburg, Sweden; Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Sahlgrenska Academy, Gothenburg, Sweden.
Sportrehab, Gothenburg, Sweden.
Sportrehab, Gothenburg, Sweden; Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Sahlgrenska Academy, Gothenburg, Sweden.
Sahlgrenska Sports Medicine Center, Gothenburg, Sweden; Sahlgrenska Academy, Gothenburg, Sweden; Center For Sports Medicine, Pittsburgh, United States.
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2024 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 34, no 2, p. 1-14, article id e14569Article in journal (Refereed) Published
Abstract [en]

Introduction: About 50% of patients who sustain an anterior cruciate ligament (ACL) injury are treated without ACL reconstruction (ACL-R). A significant proportion of these patients opt for late ACL-R. Patients' experience of changing treatment has not yet been investigated and presented in the scientific literature. Aim: To explore patients' experiences before and after changing treatment from ACL rehabilitation alone to ACL-R. Method: Fifteen patients were interviewed in semi-structured interviews, which were recorded, transcribed, and analyzed with qualitative content analysis, based on the method described by Graneheim and Lundman. Patients were between 26 and 58 years old, and had tried rehabilitation for a minimum of 9 months prior to ACL-R. Results: Two themes, “Expecting what could not be achieved: the struggle to recover and not becoming stable”, and “Internal completeness: expectations can be achieved”, emerged from the analysis. Each theme was supported by three main categories and 5–6 subcategories. The first theme represents the journey before ACL-R, where patients experienced getting stronger, but perceived the knee as unstable. The second theme represents the journey after ACL-R, where patients expressed that they felt whole after their ACL-R, and where able to achieve their expections. Patients experienced a greater support from the healthcare system, and ultimately expressed a feeling of having achieved the unachievable after ACL-R. Summary: Patients who cross over from ACL rehabilitation to ACL-R experienced rehabilitation alone as insufficient to achieve the desired outcomes, which resulted in a need to opt for delayed ACL-R. Healthcare providers need to support patients, who primarily choose to undergo rehabilitation alone and later opt for ACL-R, throughout the whole rehabilitation process. © 2024 The Authors. 

Place, publisher, year, edition, pages
West Sussex: Wiley-Blackwell Publishing Inc., 2024. Vol. 34, no 2, p. 1-14, article id e14569
Keywords [en]
ACL, anterior cruciate ligament, change treatment, crossover, late reconstruction, switch treatment, treatment choice
National Category
Health Sciences
Research subject
Health Innovation, M4HP
Identifiers
URN: urn:nbn:se:hh:diva-52739DOI: 10.1111/sms.14569ISI: 001150596800001PubMedID: 38389139Scopus ID: 2-s2.0-85183916081OAI: oai:DiVA.org:hh-52739DiVA, id: diva2:1840421
Available from: 2024-02-23 Created: 2024-02-23 Last updated: 2024-04-19Bibliographically approved

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Ivarsson, Andreas

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