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Outcome of ACLR

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https://www.readbyqxmd.com/read/29775379/decision-to-return-to-sport-participation-after-anterior-cruciate-ligament-reconstruction-part-ii-self-reported-and-functional-performance-outcomes
#1
Jennifer L Werner, Julie P Burland, Carl G Mattacola, Jenny Toonstra, Robert A English, Jennifer S Howard
CONTEXT:   Anterior cruciate ligament (ACL) reconstruction (ACLR) is the most commonly used method for helping athletes regain function and return to preinjury activity levels after ACL injury. Outcomes after ACLR have suggested that athletes return to a level of function that would support a return to sport participation; however, in a recent meta-analysis, pooled return rates were only 55%. It is unclear whether this discrepancy is a result of functional impairments. OBJECTIVE:   To compare patient-reported outcomes (PROs), dynamic balance, dynamic functional performance, strength, and muscular endurance in athletes who have returned to sport (RTS) and athletes who have not returned to sport (NRTS) after ACLR...
May 18, 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29741921/how-variable-are-achilles-allografts-used-for-anterior-cruciate-ligament-reconstruction-a-biomechanical-study
#2
Alexander E Weber, Erik N Mayer, Amit Nathani, Dan X Chen, Anne M Kelly, Scott A Rodeo, Asheesh Bedi
BACKGROUND: Allograft tendon used in anterior cruciate ligament reconstruction (ACLR) requires sterilization before implantation. Low-dose gamma irradiation is a means of sterilization that may minimize tissue damage. PURPOSE: To quantify the variability in mechanical properties between low-dose irradiated Achilles tendon allografts used for ACLR. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 15 intact outer-third Achilles tendon allograft specimens were collected from the remains of full Achilles allografts used for intraoperative ACLR at a single hospital...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29731319/the-influence-of-tibial-slope-on-the-graft-in-combined-high-tibial-osteotomy-and-anterior-cruciate-ligament-reconstruction
#3
Philipp Schuster, Markus Geßlein, Michael Schlumberger, Philipp Mayer, Jörg Richter
BACKGROUND: Young patients with severe medial osteoarthritis, varus malalignment and insufficiency of the anterior cruciate ligament (ACL) are difficult to treat. The tibial slope has gained attention with regard to osteotomies and ligamentous instability. The purpose was to evaluate the outcome of combined high tibial osteotomy (HTO), ACL reconstruction and chondral resurfacing (CR, abrasion plus microfracture), and to analyse graft failure rates with regard to the tibial slope. METHODS: Fifty cases (48...
May 3, 2018: Knee
https://www.readbyqxmd.com/read/29725748/atopic-dermatitis-is-a-novel-demographic-risk-factor-for-surgical-site-infection-after-anterior-cruciate-ligament-reconstruction
#4
Manabu Kawata, Yusuke Sasabuchi, Shuji Taketomi, Hiroshi Inui, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Sakae Tanaka
PURPOSE: Although various risk factors for surgical site infection after anterior cruciate ligament reconstruction (ACLR) have been reported, the number of studies with large sample sizes on this topic is limited. The aim of the present study was to clarify the risk factors for early surgical site infection after ACLR in a large cohort using a national database in Japan. METHODS: The data of patients who underwent ACLR from 2010 to 2015 were obtained from the Diagnosis Procedure Combination database, which covers approximately half of all hospital admissions in Japan...
May 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29718684/factors-associated-with-psychological-readiness-to-return-to-sport-after-anterior-cruciate-ligament-reconstruction-surgery
#5
Kate E Webster, Christopher V Nagelli, Timothy E Hewett, Julian A Feller
BACKGROUND: Anterior cruciate ligament (ACL) injury has a significant psychological effect, and a negative psychological state is a commonly cited reason for a reduction or cessation of sports participation after ACL reconstruction (ACLR) surgery. PURPOSE: To identify factors that contribute to an athlete's psychological readiness to return to sport (RTS) after ACLR. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A cohort of 635 athletes (389 male, 246 female) who underwent ACLR and had been cleared to RTS completed the Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale at an average 12 months (range, 11-24 months) after surgery...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29685058/the-effect-of-open-vs-closed-kinetic-chain-exercises-on-anterior-tibial-laxity-strength-and-function-following-anterior-cruciate-ligament-reconstruction-a-systematic-review-and-meta-analysis
#6
Alyssa Perriman, Edmund Leahy, Adam Ivan Semciw
Study Design Systematic review with meta-analysis. Background There is controversy surrounding the early use of Open Kinetic Chain (OKC) quadriceps strengthening exercises post anterior cruciate ligament reconstruction (ACLR) due to the belief that increased strain in the graft could cause damage. Objectives To determine if OKC quadriceps exercises result in differences in anterior tibial laxity, strength, function, quality of life or adverse events in the ACLR population, when compared to closed kinetic chain (CKC) quadriceps exercises...
April 23, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29682311/acl-reconstruction-with-hamstring-tendon-autograft-and-accelerated-brace-free-rehabilitation-a-systematic-review-of-clinical-outcomes
#7
Rob P A Janssen, Nicky van Melick, Jan B A van Mourik, Max Reijman, Lodewijk W van Rhijn
Objective: To investigate the clinical outcomes after hamstring tendon autograft ACL reconstruction (ACLR) with accelerated, brace-free rehabilitation. Design: Systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Data sources: Embase, MEDLINE Ovid, Web of Science, Cochrane CENTRAL and Google scholar from 1 January 1974 to 31 January 2017. Eligibility criteria for selecting studies: Study designs reporting outcomes in adults after arthroscopic, primary ACLR with hamstring autograft and accelerated, brace-free rehabilitation...
2018: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/29667429/quadriceps-function-knee-pain-and-self-reported-outcomes-in-patients-with-anterior-cruciate-ligament-reconstruction
#8
Adam S Lepley, Brian Pietrosimone, Marc L Cormier
CONTEXT:   Interactions among muscle strength, pain, and self-reported outcomes in patients with anterior cruciate ligament reconstruction (ACLR) are not well understood. Clarifying these interactions is of clinical importance because improving physical and psychological function is thought to optimize outcomes after ACLR. OBJECTIVE:   To examine the relationships among neuromuscular quadriceps function, pain, self-reported knee function, readiness to return to activity, and emotional response to injury both before and after ACLR...
April 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29662910/outcomes-and-return-to-sport-after-revision-anterior-cruciate-ligament-reconstruction-in-adolescent-athletes
#9
Michael Saper, Stephanie Pearce, Joseph Shung, Robert Zondervan, Roger Ostrander, James R Andrews
Background: The number of adolescent anterior cruciate ligament (ACL) injuries is rising with increased participation in higher level athletics at earlier ages. With an increasing number of primary ACL reconstructions (ACLRs) comes a rise in the incidence of revision ACLRs. Purpose: To evaluate the clinical results of revision ACLR across a group of high-level adolescent athletes with at least 2-year follow-up. Study Design: Case series; Level of evidence, 4...
April 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29628379/quadriceps-tendon-autograft-for-primary-anterior-cruciate-ligament-reconstruction-a-systematic-review-of-comparative-studies-with-minimum-two-year-follow-up
#10
REVIEW
John W Belk, Matthew J Kraeutler, Hayden A Marshall, Jesse A Goodrich, Eric C McCarty
PURPOSE: To systematically review the literature in an effort to compare outcomes of patients undergoing primary anterior cruciate ligament reconstruction (ACLR) with a quadriceps tendon (QT) autograft versus a bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) autograft. METHODS: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to locate studies (Level of Evidence I-III) comparing the clinical outcomes of the QT autograft versus the BPTB or HT autograft in patients undergoing primary ACLR...
April 5, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29596099/evidence-basis-for-regional-anesthesia-in-ambulatory-anterior-cruciate-ligament-reconstruction-part-i-femoral-nerve-block
#11
Leon Vorobeichik, Richard Brull, Girish P Joshi, Faraj W Abdallah
The optimal management of pain after ambulatory anterior cruciate ligament reconstruction (ACLR) is unclear. Femoral nerve block (FNB) is purported to enhance postoperative analgesia, but its effectiveness in the setting of modern multimodal analgesia is unclear. This systematic review examines the effect of adding FNB to multimodal analgesia on analgesic outcomes after ACLR, whether or not the analgesic regimen used included local instillation analgesia (LIA). We retrieved randomized controlled trials evaluating the effects of adding FNB to multimodal analgesia on analgesic outcomes after ACLR, compared to multimodal analgesia alone (control)...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29589954/validation-of-an-mri-protocol-for-routine-quantitative-assessment-of-tunnel-position-in-anterior-cruciate-ligament-reconstruction
#12
Samuel Grasso, James Linklater, Qing Li, David A Parker
BACKGROUND: No standardized methodology and objective criteria currently exist to accurately and objectively assess tunnel placement and consequent graft orientation in anterior cruciate ligament (ACL) reconstruction (ACLR) through a single imaging modality. Advances in magnetic resonance imaging (MRI) technology have enabled the use of volumetric high spatial and contrast resolution proton density-weighted sequencing, which allows precise delineation of graft orientation, tunnel position, and quantitative assessment of tunnel position relationship to adjacent reproducible anatomic landmarks...
March 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29589505/biological-augmentation-of-graft-healing-in-anterior-cruciate-ligament-reconstruction
#13
REVIEW
A T Hexter, T Thangarajah, G Blunn, F S Haddad
Aims The success of anterior cruciate ligament reconstruction (ACLR) depends on osseointegration at the graft-tunnel interface and intra-articular ligamentization. Our aim was to conduct a systematic review of clinical and preclinical studies that evaluated biological augmentation of graft healing in ACLR. Materials and Methods In all, 1879 studies were identified across three databases. Following assessment against strict criteria, 112 studies were included (20 clinical studies; 92 animal studies). Results Seven categories of biological interventions were identified: growth factors, biomaterials, stem cells, gene therapy, autologous tissue, biophysical/environmental, and pharmaceuticals...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29576645/anterior-cruciate-ligament-reconstruction-with-tibial-attachment-preserving-hamstring-graft-without-implant-on-tibial-side
#14
Skand Sinha, Ananta Kumar Naik, Mridul Maheshwari, Sumedh Sandanshiv, Durgashankar Meena, Rajendra K Arya
Background: Tibial attachment preserving hamstring graft could prevent potential problems of free graft in anterior cruciate ligament (ACL) reconstruction such as pull out before graft-tunnel healing or rupture before ligamentization. Different implants have been reportedly used for tibial side fixation with this technique. We investigated short-term outcome of ACL reconstruction (ACLR) with tibial attachment sparing hamstring graft without implant on the tibial side by outside in technique...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29552571/septic-arthritis-after-anterior-cruciate-ligament-reconstruction-clinical-and-functional-outcomes-based-on-graft-retention-or-removal
#15
Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29550753/return-to-pivoting-sport-after-acl-reconstruction-association-with-osteoarthritis-and-knee-function-at-the-15-year-follow-up
#16
Britt Elin Øiestad, Inger Holm, May Arna Risberg
OBJECTIVES: To examine the associations between return to pivoting sport following ACL reconstruction (ACLR) and knee osteoarthritis (OA), and self-reported knee symptoms, function and quality of life after 15 years. METHODS: Study sample included 258 participants with ACLR 15 years previously. Return to pivoting sport (handball, soccer and basketball) data were collected by interviews, and symptomatic OA was defined as Kellgren and Lawrence grade ≥2 plus almost daily knee pain in the last month...
March 17, 2018: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/29536023/male-sex-decreased-activity-level-and-higher-bmi-associated-with-lower-completion-of-patient-reported-outcome-measures-following-acl-reconstruction
#17
Eric J Cotter, Charles P Hannon, Philip Locker, Annabelle Davey, Kevin C Wang, Nikhil N Verma, Brian J Cole
Background: Patient-reported outcome (PRO) surveys have become increasingly important in both improving patient care and assessing outcomes. Purpose/Hypothesis: The purpose of this study was to evaluate which variables are associated with compliance with completing PRO surveys in patients who have undergone anterior cruciate ligament reconstruction (ACLR). The authors hypothesized that older patient age and longer time since ACLR would be associated with lower completion rates of PRO surveys preoperatively and at postoperative time points...
March 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29528481/all-inside-anterior-cruciate-ligament-reconstruction-a-systematic-review-of-techniques-outcomes-and-complications
#18
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
https://www.readbyqxmd.com/read/29525545/time-between-anterior-cruciate-ligament-injury-and-reconstruction-and-cartilage-metabolism-six-months-following-reconstruction
#19
Hope C Davis, Jeffery T Spang, Richard F Loeser, Staffan Larsson, Veronica Ulici, J Troy Blackburn, R Alexander Creighton, Ganesh M Kamath, Joanne M Jordan, Stephen W Marshall, Brian Pietrosimone
BACKGROUND: To determine the association between time from injury to ACL reconstruction (TimeInjury-ACLR ) and biochemical markers of cartilage metabolism and inflammation six months following ACL reconstruction (ACLR). METHODS: Individuals with a unilateral ACL injury were enrolled at initial presentation in the orthopedic clinic; blood was collected six months following ACLR. Enzyme-linked immunosorbent assays were used to analyze the ratio of serum concentrations of type-II collagen breakdown (C2C) to synthesis (CPII), plasma matrix metalloproteinase-3 (MMP-3), interleukin-6 (IL-6), and serum aggrecan neoepitope (ARGS)...
March 2018: Knee
https://www.readbyqxmd.com/read/29511820/no-evidence-for-the-most-appropriate-postoperative-rehabilitation-protocol-following-anterior-cruciate-ligament-reconstruction-with-concomitant-articular-cartilage-lesions-a-systematic-review
#20
REVIEW
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...
April 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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