ORIGINAL RESEARCH article
Front. Sports Act. Living
Sec. Injury Prevention and Rehabilitation
Volume 7 - 2025 | doi: 10.3389/fspor.2025.1641750
This article is part of the Research TopicOvercoming Hurdles in ACL Injury Recovery: Multidisciplinary Strategies for Enhanced Return to SportView all 3 articles
Club-Based vs. Hospital-Guided Rehabilitation After ACL Reconstruction in Football Participants: A Two-Year Prospective Cohort Study
Provisionally accepted
- 1Dongbei University of Finance and Economics, Dalian, China
- 2Fudan University, Shanghai, China
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Background: Anterior cruciate ligament (ACL) injury is a common and serious problem in football. While reconstruction restores knee stability, postoperative rehabilitation critically influences long-term outcomes, especially return to sport (RTS). However, comparative evidence on the long-term efficacy of hospital-guided versus club-based rehabilitation remains limited. Purpose: To compare two-year clinical outcomes and RTS rates between hospital-guided and club-based rehabilitation programs following ACL reconstruction in football players. Methods: In this prospective cohort study, 40 football participants underwent primary ACL reconstruction and were assigned to hospital-guided (n=20) or club-based rehabilitation (n=20). The hospital program emphasized basic joint function recovery, while the club program focused on sport-specific conditioning and performance enhancement. Outcome measures included subjective functional scores (Tegner Activity Score, Marx Activity Rating Scale, IKDC subjective score, Lysholm Knee Rating Scale, ACL-RSI), objective knee function (effusion, range of motion, joint stability), time to return to training and competition, and re-injury rate. Results: Baseline characteristics were comparable. The club-based group showed significantly better outcomes in Tegner (8.5 ± 1.4 vs. 7.2 ± 1.0, p=0.006), Marx (12.7 ± 2.8 vs. 10.6 ± 2.7, p=0.019), and ACL-RSI (73.3 ± 21.4 vs. 54.3 ± 18.7, p=0.003) scores. They also returned to training and competition significantly earlier. No significant differences were found in range of motion, joint stability, or re-injury rates. Conclusion: Club-based rehabilitation led to superior subjective function, greater psychological readiness, and earlier RTS compared to hospital-guided programs without increasing re-injury risk. These findings support integrating sport-specific rehabilitation elements for football players after ACL reconstruction, while further research is needed to confirm long-term safety and cost-effectiveness.
Keywords: Anterior Cruciate Ligament, Football, Rehabilitation, Club-based, Hospital-guided
Received: 05 Jun 2025; Accepted: 16 Jul 2025.
Copyright: © 2025 Han, Sun, Chen and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tianwu Chen, Fudan University, Shanghai, China
Yu Dong, Fudan University, Shanghai, China
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