Smart-Monitoring–Guided Rehabilitation Improves Early Functional Recovery and Reduces Complications After Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Study

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Abstract
Background: Postoperative rehabilitation critically determines functional outcomes after anterior cruciate ligament (ACL) reconstruction. Conventional programs often lack real-time feedback and objective monitoring, limiting adherence and recovery efficiency. Smart-monitoring systems integrating wearable sensors and mobile applications may enhance rehabilitation through continuous supervision and data-driven optimization. Methods: In this prospective observational cohort study, 170 patients undergoing primary ACL reconstruction (85 smart-monitoring, 85 conventional) were followed for 12 weeks. The smart-monitoring cohort used a mobile app with wearable sensors to track range of motion (ROM), training frequency, and pain feedback, whereas the control cohort performed standard home-based rehabilitation. Primary outcomes included good functional recovery (IKDC ≥80 or ROM ≥120°) and longitudinal changes in IKDC, Lysholm, and muscle strength. Logistic regression identified independent predictors, and receiver operating characteristic (ROC) curves evaluated model performance. Results: The smart-monitoring cohort achieved significantly greater improvements in IKDC, Lysholm, ROM, and quadriceps strength (all P < 0.01), faster pain reduction, and fewer complications (4.9% vs. 16.7%, P = 0.02). Rehabilitation adherence was markedly higher (91.3% vs. 73.8%, P < 0.001). Smart intervention (OR = 0.32, 95% CI: 0.14–0.70, P = 0.004) and adherence ≥85% (OR = 0.45, 95% CI: 0.21–0.92, P = 0.030) were independent protective factors for good recovery. The predictive model integrating smart intervention, adherence, and preoperative IKDC achieved the highest discriminative power (AUC = 0.88, 95% CI: 0.81– 0.93). Conclusions: Smart-monitoring–guided rehabilitation significantly accelerates functional recovery, enhances adherence, and reduces postoperative complications after ACL reconstruction. The combined smart–clinical model provides strong predictive accuracy for favorable outcomes, supporting the role of digital rehabilitation in precision recovery management.
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Authors Yongli, Jia
Journal Frontiers in surgery
Year Year not found
DOI
10.3389/fsurg.2026.1737613
URL
https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2026.1737613/full
Keywords Keywords not found

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