Quality control circles in rehabilitation after anterior cruciate ligament reconstruction: An observational study

Abstract

Rehabilitation following anterior cruciate ligament (ACL) injury is crucial for restoring athletic function. The Quality Control Circle (QCC), known for promoting continuous improvement in various medical fields, may improve outcomes following ACL reconstruction (ACLR). This study evaluates the effectiveness of a QCC-guided rehabilitation approach in patients following ACLR. A retrospective analysis was conducted on 142 patients who underwent ACLR, divided into 2 groups based on their rehabilitation period. The control group (n = 71) received conventional rehabilitation. The experimental group underwent rehabilitation guided by the QCC. Both groups were assessed at 2, 4, 8 weeks, and 6 months post-rehabilitation for Lysholm knee function scores, Visual Analog Scale, proprioception at knee joint angles of 15°, 35°, and 75°, peak torque relative to body weight (PT/BW), flexion (PTflex), and extension peak torque values, and hamstring-to-quadriceps strength ratio. Patient improvement rate, participation rate, satisfaction score, willingness to recommend, recurrence rate, rehabilitation efficiency, adverse event rate, and adherence to guidelines were also evaluated through questionnaires. At 2 weeks, the experimental group showed significantly higher proprioception at 35° and 75° knee joint angles, PTflex, hamstring-to-quadriceps strength ratio, satisfaction score, willingness to recommend, rehabilitation efficiency, and adherence to guidelines compared to the control group (P < .05). At 4 weeks, improvements were noted in proprioception at 15°, 35°, and 75° angles, PTflex, peak torque extension, improvement rate, participation rate, satisfaction score, willingness to recommend, rehabilitation efficiency, and adherence to guidelines (P  < .05). Implementing the QCC method in post-ACLR rehabilitation significantly enhances knee joint function, reduces pain, improves proprioception and muscle strength, and increases patient satisfaction and engagement. This approach provides an effective rehabilitation model for ACLR patients by promoting interdisciplinary team collaboration and continuous quality improvement.