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acl reconstruction rehabilitation

Darren de Sa, Ajaykumar Shanmugaraj, Melissa Weidman, Devin C Peterson, Nicole Simunovic, Volker Musahl, Olufemi R Ayeni
The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context...
February 8, 2018: Journal of Knee Surgery
Anne Benjaminse, Sinead Holden, Gregory D Myer
The authors present their thoughts on the focus on targeting asymmetry in rehabilitation after ACL reconstruction, which they think may not be rich enough to identify deficits.
March 8, 2018: British Journal of Sports Medicine
Ciaran Thrush, Tabitha J Porter, Brian M Devitt
PURPOSE: Anterior cruciate ligament (ACL) rupture commonly occurs in conjunction with articular cartilage injury. However, there is no consensus on the most appropriate rehabilitation which should be carried out for ACL reconstruction (ACLR) and the surgical management of articular cartilage lesions of the knee. The purpose of this study was to systematically review the literature to investigate the recommended rehabilitation protocol for patients undergoing ACLR with concomitant articular cartilage injury with a view to develop guidelines on the most appropriate treatment...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Thomas Bartels, Kay Brehme, Martin Pyschik, Stephan Schulze, Karl-Stefan Delank, Georg Fieseler, Kevin G Laudner, Souhail Hermassi, René Schwesig
There are currently no longitudinal data describing the pre- and postoperative postural regulation and stability of patients with anterior cruciate ligament (ACL) damage. Therefore, the aim of this study was to evaluate postural regulation and stability prior to and during rehabilitation following surgery of the ACL. Fifty-four physically active subjects (age: 30.5±10.9 years, 29 male subjects) were examined with the Interactive Balance System pre-, 6, and at 12 weeks following surgical reconstruction of the ACL using a hamstring tendon graft...
February 2018: Journal of Exercise Rehabilitation
Julie P Burland, Jenny Toonstra, Jennifer L Werner, Carl G Mattacola, Dana M Howell, Jennifer S Howard
CONTEXT:   Return-to-sport criteria after anterior cruciate ligament (ACL) injury are often based on "satisfactory" functional and patient-reported outcomes. However, an individual's decision to return to sport is likely multifactorial; psychological and physical readiness to return may not be synonymous. OBJECTIVE:   To determine the psychosocial factors that influence the decision to return to sport in athletes 1 year post-ACL reconstruction (ACLR)...
March 5, 2018: Journal of Athletic Training
Riley J Williams
In contrast to anterior cruciate ligament reconstruction, there is a paucity of primary studies that address the issue of return to play after anterior shoulder stabilization for glenohumeral instability. Most studies focused on clinical outcomes after anterior shoulder stabilization provide little detail on the authors' assessment protocols used in determining return to sport readiness. In fact, many issues germane to the postoperative rehabilitation process (biologic healing, motion recovery, strength recovery, and sport-specific considerations) remain poorly defined, and are not typically addressed using validated shoulder outcomes instruments...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Robert G Willson, Regina O Kostyun, Matthew D Milewski, Carl W Nissen
Background: Reconstruction of the anterior cruciate ligament (ACL) in the skeletally immature patient is frequently performed in hopes of preventing new or additional chondral damage and meniscal injuries. Patients within a few years of skeletal maturity are more at risk for ACL injuries than prepubescent patients, about whom several physeal-sparing techniques have been described. Reconstruction techniques in the former higher risk group need to be better understood. Purpose: To review a series of adolescent patients with ACL injuries surgically treated with the hybrid physeal-sparing technique...
February 2018: Orthopaedic Journal of Sports Medicine
Jelle P van der List, Gregory S DiFelice
The medial collateral ligament (MCL) is commonly injured in the setting of anterior cruciate ligament (ACL) injuries. Because the MCL has better healing capacity than the ACL, the general perception is that MCL injuries can be treated conservatively. Treating these injuries conservatively, however, can lead to residual valgus laxity. Furthermore, it delays time to surgery, which prevents acute treatment of concomitant ACL injuries using primary repair or acute reconstruction. Several treatment methods for MCL injuries have been proposed, including primary repair, augmented repair with autograft tissue, or primary reconstruction...
August 2017: Arthroscopy Techniques
Bin Wu, Song Zheng, Zhen-Hai Cai, Yue-Li Wang, Ming Zeng
OBJECTIVE: To observe the effect of core strength training on knee joint function and postural stability after anterior cruciate ligament reconstruction (ACLR). METHODS: A total of 80 ACLR patients were randomly allocated into conventional rehabilitation training group and core strength training group from May 2013 to May 2015 with 40 patients in each group. The patients in conventional rehabilitation training group underwent conventional ACLR rehabilitation training, in which 28 males and 12 females...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mohamed Aboalata, Ashraf Elazab, Abdelsamie Halawa, Andreas B Imhoff, Yehia Bassiouny
The anterior cruciate ligament suture augmentation technique is a method to augment anterior cruciate ligament reconstruction (ACLR) with autologous hamstring tendons using a braided ultrahigh-molecular weight polyester or polyethylene suture or suture tape and fixed on both the femoral and tibial sides independent of the graft to act as a backup or secondary stabilizer until complete integration and ligamentization of the graft take place. The technique is proposed to allow early rehabilitation and return to sports after ACLR and may be advantageous in patients with a high body mass index and in cases with small grafts (7 or 7...
October 2017: Arthroscopy Techniques
Hanna Tigerstrand Grevnerts, Anne Fältström, Sofi Sonesson, Håkan Gauffin, Siw Carlfjord, Joanna Kvist
PURPOSE: The purpose of the study was to (1) study and compare the factors that Swedish orthopaedic surgeons and physical therapists consider important for recommending ACL reconstruction and, (2) to assess how orthopaedic surgeons and physical therapists consider their own and each others, as well as patients', roles are in the treatment decision. METHODS: A web-based survey assessing the relevance of 21 predetermined factors, in the choice to recommend ACL reconstruction, was sent to orthopaedic surgeons and physical therapists...
February 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Eric Hamrin Senorski, Eleonor Svantesson, Susanne Beischer, Christoffer Thomeé, Alberto Grassi, Ferid Krupic, Roland Thomeé, Jón Karlsson, Kristian Samuelsson
PURPOSE: A better understanding of patient characteristics and the way common concomitant injuries affect the recovery of muscle function after surgery should help providers to treat patients with anterior cruciate ligament (ACL) injuries. The aim of this study was to determine whether patient characteristics, concomitant injuries and graft choice at ACL reconstruction were associated with symmetrical knee muscle function at one year. The hypothesis was that the presence of concomitant injuries would negatively influence the opportunity to achieve symmetrical knee function at the one-year follow-up...
February 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Zhen-Yu Jia, Jin Cui, Wei Wang, Chen-Chen Xue, Tian-Ze Liu, Xuan Huang, Wei-Dong Xu
PURPOSE: The aim of this study is to obtain a translation and adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) into simplified Chinese and validate the simplified Chinese version. METHODS: Translation and adaptation were performed according to the guidelines of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 122 patients who were diagnosed with an ACL injury and underwent primary arthroscopic anterior cruciate ligament reconstruction (ACLR) between 2015 and 2016 were included in this study...
February 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Birgit Friedmann-Bette, Francesca Profit, Thomas Gwechenberger, Nadine Weiberg, Mario Parstorfer, Marc-Andre Weber, Nikolaus Streich, Alexander Barié
PURPOSE: Protracted quadriceps muscle atrophy is observed after anterior cruciate ligament reconstruction (ACL-R). The aim of this study was to assess if quadriceps strength training with eccentric overload (CON/ECC) is more efficient to induce muscle regeneration after ACL-R than conventional concentric/eccentric (CON/ECC) strength training. METHODS: Biopsies from the vastus lateralis muscle were obtained from 37 recreational athletes after 12 weeks of regular rehabilitation following ACL-R and again after 12 weeks with twice a week either conventional CON/ECC (n = 16) or CON/ECC (n = 21) one-legged supervised leg-press training...
January 31, 2018: Medicine and Science in Sports and Exercise
Mikko Laakso, Jussi Kosola, Pekka Niemi, Keijo Mäkelä, Juha Ranne, Sakari Orava, Lasse Lempainen
Background: Semitendinosus (ST) is widely used autograft in anterior cruciate ligament reconstructions (ACLR). Although tendon harvesting is a common procedure, some patients exhibit pain, cramping and dysfunctional at posterior thigh after the ACLR. The formation of the newly regenerated neotendon could be compromised by a new injury or too rapid rehabilitation. We present this clinical entity and the developed surgical technique and share our experience in treatment of these patients...
July 2017: Muscles, Ligaments and Tendons Journal
Bo Bregenhof, Uffe Jørgensen, Per Aagaard, Nis Nissen, Mark W Creaby, Jonas Bloch Thorlund, Carsten Jensen, Trine Torfing, Anders Holsgaard-Larsen
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction, using hamstring auto-graft is a common surgical procedure, which often leads to persistent hamstring muscle-strength deficiency and reduced function. The purpose of this randomized controlled trial (RCT) is to investigate the effect of a combined, progressive, strength and neuromuscular exercise intervention on knee muscle strength, functional capacity and hamstring muscle-tendon morphology in ACL-reconstructed patients with persistent hamstring muscle-strength deficiency compared with controls...
January 26, 2018: Trials
Han Chang, Xiang-Yu Tang, Feng Qu, Xue-Zhen Shen, Jiang-Tao Wang, Chun-Bao Li, Wei Qi, Yu-Jie Liu
Anterior cruciate ligament injury is one of the most common injuries of knee joint. Arthroscopic reconstruction of anterior cruciate ligament is the most commonly performed procedure. A variety type of fixation techniques are being used nowadays, such as interference screw, cortical suspension fixation and transfix, all of which can achieve good effect, with both advantages and disadvantages. However, the healing of reconstructed grafts is a complicated and long-term process, which can be affected by many factors...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mohamed Aboalata, Ashraf Elazab, Abdelsamie Halawa, Moheib S Ahmed, Andreas B Imhoff, Yehia Bassiouny
The crossing internal suture augmentation technique is an all-inside technique of anterior cruciate ligament reconstruction with augmentation of the hamstring tendon autograft with a braided ultrahigh-molecular-weight polyester-polyethylene suture tape resting on the adjustable cortical buttons on both the femoral and tibial sides. The internal suture augmentation acts as a backbone supporting and protecting the graft until the process of healing and ligamentization of the graft is completed. The ends of the suture tape are tied on the tibial button and additionally fixed to the tibia with a knotless anchor as a backup fixation with the knee in full extension...
December 2017: Arthroscopy Techniques
Nur Liyana Azmi, Ziyun Ding, Rui Xu, Anthony M J Bull
The anterior cruciate ligament (ACL) provides resistance to tibial internal rotation torque and anterior shear at the knee. ACL deficiency results in knee instability. Optimisation of muscle contraction through functional electrical stimulation (FES) offers the prospect of mitigating the destabilising effects of ACL deficiency. The hypothesis of this study is that activation of the biceps femoris long head (BFLH) reduces the tibial internal rotation torque and the anterior shear force at the knee. Gait data of twelve healthy subjects were measured with and without the application of FES and taken as inputs to a computational musculoskeletal model...
2018: PloS One
Richard Ma, Michael Schär, Tina Chen, Marco Sisto, Joseph Nguyen, Clifford Voigt, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Anterior cruciate ligament (ACL) grafts that are placed for reconstruction are subject to complex forces. Current "anatomic" ACL reconstruction techniques may result in greater in situ graft forces. The biological effect of changing magnitudes of ACL graft force on graft-tunnel osseointegration is not well understood. PURPOSE: The research objective is to determine how mechanical force on the ACL graft during knee motion affects tendon healing in the tunnel...
January 1, 2018: American Journal of Sports Medicine
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