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ACL reconstruction and quadriceps

Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Santiago Gonzalez-Parreño, Luis Marco-Gomez, Francisco A Miralles Muñoz, Fernando A Lopez-Prats
BACKGROUND: Few studies have analyzed the outcomes of total knee arthroplasty (TKA) in patients with prior anterior cruciate ligament (ACL) reconstruction, and the reported outcomes are controversial. The purpose of this study is to assess if prior ACL reconstruction had any impact on the outcome of subsequent TKA. METHODS: A matched case-control study was conducted in patients who underwent TKA, including 37 with prior ACL reconstruction and 37 patients without ACL reconstruction...
February 21, 2018: Journal of Arthroplasty
Marie E Boo, J Craig Garrison, Joseph P Hannon, Kalyssa M Creed, Shiho Goto, Angellyn N Grondin, James M Bothwell
Background: Female patients are more likely to suffer a second anterior cruciate ligament (ACL) injury after ACL reconstruction (ACLR) and return to sport (RTS) compared with healthy female controls. Few studies have examined the energy absorption contribution (EAC) that could lead to this subsequent injury. Hypothesis: The ACLR group would demonstrate an altered EAC between joints (hip, knee, and ankle) but no difference in quadriceps, hip abduction, or hip external rotation (ER) strength at the time of RTS...
March 2018: Orthopaedic Journal of Sports Medicine
João Victor Novaretti, Carlos Eduardo Franciozi, Andrea Forgas, Pedro Henrique Sasaki, Sheila Jean McNeill Ingham, Rene Jorge Abdalla
BACKGROUND: There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR). HYPOTHESES: Patients who return to their preinjury level of sport will have higher isokinetic, postural stability, and drop vertical jump test scores 6 months after surgery and greater patient satisfaction compared with those who did not...
February 1, 2018: Sports Health
Cristian Tudor Buescu, Cristian Mircea Dudescu, Sergiu Caterev, Dan Gheorghe Osvald Lucaciu
Background and aims: Using free quadriceps tendon graft for anterior cruciate ligament (ACL) reconstruction has become more popular in the last years due to the low morbidity at the harvest site and biomechanical and structural properties similar to other types of graft (hamstring and patellar tendons). As long as the tibial tunnel fixation with interference screws is considered the standard fixation, femoral fixation is still an open subject. Even though the most common type of femoral tunnel fixation are the cortical suspension devices, the type of suture used for tying the graft to the loop is still evaluated and discussed...
2018: Clujul Medical (1957)
Yoon-Ho Kwak, Sahnghoon Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: Quadriceps tendon-patellar bone (QTPB) autograft is an excellent graft option with good clinical outcome. Use of QTPB autografts have increased because they minimize donor-site morbidity including anterior knee pain, while providing adequate mechanical strength. Although, there were many clinical results about allografts that used in anterior cruciate ligament (ACL) reconstruction, it have never been reported about the clinical outcome of ACL reconstruction with QTPB allograft...
February 9, 2018: BMC Musculoskeletal Disorders
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
Lawrence Camarda, Emanuele Grassedonio, Domenico Albano, Massimo Galia, Massimo Midiri, Michele D'Arienzo
Background: The aim of this study is to evaluate a possible correlation between specific anthropometric parameters and sizes of knee tendons commonly used for ACL reconstruction. We hypothesized that specific clinical and radiological knee measurements could be better tendon sizes predictors than age, gender, height and weight. Materials and methods: 100 consecutive patients were enrolled and 77 patients met the inclusion criteria of the study. All patients underwent a MRI of the knee with a 1...
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
Jonathan P Gumucio, Kristoffer B Sugg, Elizabeth R Sibilsky Enselman, Alexis C Konja, Logan R Eckhardt, Asheesh Bedi, Christopher L Mendias
INTRODUCTION: Patients with anterior cruciate ligament (ACL) tears have persistent quadriceps strength deficits that are thought to be due to altered neurophysiological function. Our goal was to determine the changes in muscle fiber contractility independent of the ability of motor neurons to activate fibers. METHODS: We obtained quadriceps biopsies of patients undergoing ACL reconstruction, and additional biopsies one, two, and six months after surgery. Muscles fiber contractility was assessed in vitro, along with whole muscle strength testing...
January 18, 2018: Muscle & Nerve
Felipe Machado, Pedro Debieux, Camila Cohen Kaleka, Diego Astur, Maria Stella Peccin, Moisés Cohen
OBJECTIVE: To compare knee isokinetic performance six months after reconstruction of the anterior cruciate ligament using grafts from either the patellar tendon or the hamstrings among patients who underwent the same rehabilitation protocol. METHODS: Thirty-four patients were evaluated (17 with grafts from the patellar tendon and 17 with grafts from the hamstrings). Operated and non-operated knees were compared with regards to the variables of peak torque, work and the hamstring/quadriceps relationship at velocities of 60º/s and 180º/s and power of 180º/s after six months of surgery...
December 19, 2017: Physician and Sportsmedicine
Cassidy Hallagin, J Craig Garrison, Kalyssa Creed, James M Bothwell, Shiho Goto, Joseph Hannon
Background: Pre-operative quadriceps strength may have a positive influence on post-operative function and outcomes at time of return to sport. Little consideration has been given to quadriceps strength during the early post-operative timeframes. Twelve-week post-operative anterior cruciate ligament reconstruction (ACL-R) is considered a critical time point for progression in the rehabilitation process. There is currently limited research looking at the relationship between clinical measurements pre-operatively and at 12-weeks following ACL-R...
November 2017: International Journal of Sports Physical Therapy
James E Christensen, Natalie E Taylor, Scott J Hetzel, John A Shepler, Tamara A Scerpella
Background: Recent evidence shows a delayed return to sport in children and delayed quadriceps recovery in both adults and children who have undergone anterior cruciate ligament (ACL) reconstruction with concomitant femoral nerve blockade (FNB) compared with those who had no blockade. We evaluated the use of adductor canal blockade (ACB), as an alternative to FNB, at the time of ACL reconstruction. Hypothesis: Patients who receive ACB will have greater isokinetic strength at 6 months postoperative compared with patients who receive FNB at the time of ACL reconstruction...
November 2017: Orthopaedic Journal of Sports Medicine
Hayri Baran Yosmaoğlu, Gül Baltacı, Emel Sönmezer, Hamza Özer, Deha Doğan
OBJECTIVES: This study aims to compare the effects of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring or patellar tendon graft on the peak torque angle. PATIENTS AND METHODS: The study included 132 patients (103 males, 29 females; mean age 29±9 year) who were performed ACL reconstruction with autogenous hamstring or patellar tendon graft. The peak torque angles in the quadriceps and hamstring muscles were recorded using an isokinetic dynamometer...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Andrea Pasquini, Marco Jacopetti, Francesco Pogliacomi, Ileana Ramazzina, Cosimo Costantino
OBJECTIVE: Several different types of grafts have been used in ACL rupture. The purpose of the study was to compare the recovery of lower limbs muscle strength and proprioception in athletes, who underwent ACL reconstruction with Bone-Patellar-Tendon-Bone (BPTB) versus semitendinosus and gracilis (HS) autografts. METHODS: We enrolled 30 male amateur athletes. Each patient was evaluated by isokinetic test, triaxial accelerometer test and balance test with stabilometric platform...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
Luciana Labanca, Jacopo Emanuele Rocchi, Luca Laudani, Rita Guitaldi, Alessandro Virgulti, Pier Paolo Mariani, Andrea Macaluso
PURPOSE: Quadriceps weakness and asymmetrical loading of lower limbs are two major issues following anterior cruciate ligament reconstruction (ACLR). The aim of this study was to evaluate the effectiveness of a 6-week training protocol involving neuromuscular electrical stimulations (NMES) of the quadriceps muscle superimposed on repeated sit-to-stand-to-sit exercises (STSTS), as an additional treatment to standard rehabilitation, from the 15th to the 60th day following ACLR. METHODS: Sixty-three ACLR patients were randomly allocated to one of the three treatment groups: NMES superimposed on STSTS (NMES+STSTS), STSTS only, or no additional treatment (NAT) to standard rehabilitation...
October 20, 2017: Medicine and Science in Sports and Exercise
Thomas J Kremen, Landon S Polakof, Sean S Rajaee, Trevor J Nelson, Melodie F Metzger
BACKGROUND: A hamstring autograft is commonly used in anterior cruciate ligament (ACL) reconstruction (ACLR); however, there is evidence to suggest that the tendons harvested may contribute to medial knee instability. HYPOTHESIS: We tested the hypothesis that the gracilis (G) and semitendinosus (ST) tendons significantly contribute to sagittal, coronal, and/or rotational knee stability in the setting of ACLR with a concurrent partial medial collateral ligament (MCL) injury...
October 1, 2017: American Journal of Sports Medicine
Timothy Lowe, Xuanliang Neil Dong
Arthrogenic muscle inhibition, an inability to fully activate the quadriceps muscles, has been persistently observed after anterior cruciate ligament reconstruction (ACLr) surgery. Reductions in quadriceps activation may be partly due to the flexion reflex pathway, hamstrings activation, and reciprocal quadriceps inhibition. Since central fatigue has been shown to modify hamstring excitability and change the hamstring reflex response, hamstring fatigue might alleviate quadriceps muscle inhibition by counteracting the flexion reflex...
January 1, 2017: Perceptual and Motor Skills
Derek N Pamukoff, Melissa M Montgomery, Tyler J Moffit, Michael N Vakula
PURPOSE: Individuals with anterior cruciate ligament reconstruction (ACLR) are at greater risk for knee osteoarthritis, partially because of chronic quadriceps dysfunction. Articular cartilage is commonly assessed using magnetic resonance imaging and radiography, but these methods are expensive and lack portability. Ultrasound imaging may provide a cost-effective and portable alternative for imaging the femoral cartilage. The purpose of this study was to compare ultrasonography of the femoral cartilage between the injured and uninjured limbs of individuals with unilateral ACLR, and to examine the association between quadriceps function and ultrasonographic measures of femoral cartilage...
February 2018: Medicine and Science in Sports and Exercise
Allison R Toole, Matthew P Ithurburn, Mitchell J Rauh, Timothy E Hewett, Mark V Paterno, Laura C Schmitt
Study Design Prospective cohort study. Background While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. Objectives To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs...
November 2017: Journal of Orthopaedic and Sports Physical Therapy
Zakariya Nawasreh, David Logerstedt, Kathleen Cummer, Michael Axe, May Arna Risberg, Lynn Snyder-Mackler
BACKGROUND: Assessing athletes' readiness is a key component for successful outcomes after ACL reconstruction (ACLR). OBJECTIVES: To investigate whether return-to-activity criteria, individually or in combination, at 6 months after ACLR can predict return to participation in the same preinjury activity level at 12 and 24 months after ACLR. METHODS: Ninety-five level I/II participants completed return-to-activity criteria testing (isometric quadriceps index, single-legged hop tests, Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and Global Rating Score (GRS)) at 6 months after ACLR...
September 27, 2017: British Journal of Sports Medicine
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