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ACL and REHABILITATION

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https://www.readbyqxmd.com/read/28522238/biomechanical-comparison-of-four-coupled-fixation-systems-for-acl-reconstruction-with-bone-socket-or-full-tunnel-on-the-tibial-side
#1
Edoardo Monaco, Mattia Fabbri, Riccardo Maria Lanzetti, Andrea Del Duca, Luca Labianca, Andrea Ferretti
BACKGROUND: To compare in an animal model the biomechanical properties of four coupled fixation devices currently used in ACL reconstruction. Three out of four devices used a full tibial tunnel with an interference screw, while the other one system used a tibial socket and an adjustable loop suspension device. The null hypothesis is that there are no biomechanical differences between all the techniques tested. METHODS: Thirty two femur-graft-tibia complexes were mounted on a tensile machine using bovine digital extensor tendons, porcine knees and four different fixation device combinations: After a preconditioning with a tensile load of 90N for five minutes, 1000cycles between 0 and 150N were applied to the complex before the final pulled to failure...
May 15, 2017: Knee
https://www.readbyqxmd.com/read/28522220/surgical-reconstruction-of-ruptured-anterior-cruciate-ligament-prolongs-trauma-induced-increase-of-inflammatory-cytokines-in-synovial-fluid-an-exploratory-analysis-in-the-kanon-trial
#2
Staffan Larsson, André Struglics, L Stefan Lohmander, Richard Frobell
OBJECTIVE: Prospectively monitor how treatment of acutely ruptured anterior cruciate ligament (ACL) affects biomarkers of inflammation and proteolytic degradation over five years. DESIGN: We studied 119 subjects with acute ACL injury from the randomized controlled KANON-trial (Clinical trial ISRCTN 84752559) who had synovial fluid, serum and urine samples available from at least two out of six visits over five years after acute ACL rupture. All subjects followed a similar rehabilitation protocol where, according to randomization, 60 also had early ACL reconstruction and 59 had the option to undergo a delayed ACL reconstruction if needed...
May 15, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28515057/delaying-acl-reconstruction-and-treating-with-exercise-therapy-alone-may-alter-prognostic-factors-for-5-year-outcome-an-exploratory-analysis-of-the-kanon-trial
#3
Stephanie R Filbay, Ewa M Roos, Richard B Frobell, Frank Roemer, Jonas Ranstam, L Stefan Lohmander
AIM: Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured individuals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. METHODS: Exploratory analysis of the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial (ISRCTN84752559). Relationships between prognostic factors (baseline cartilage, meniscus and osteochondral damage, baseline extension deficit, baseline patient-reported outcomes, number of rehabilitation visits, graft/contralateral ACL rupture, non-ACL surgery and ACL treatment strategy) and 5-year Knee Injury and Osteoarthritis Outcome Score (KOOS) pain, symptoms, sport/recreation and quality of life (QOL) scores were explored using multivariable linear regression...
May 17, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28507781/isolated-posterior-cruciate-ligament-tears-an-update-of-management
#4
REVIEW
Alfonso Vaquero-Picado, E Carlos Rodríguez-Merchán
Isolated posterior cruciate ligament (PCL) tears are much less frequent than anterior cruciate ligament (ACL) tears.Abrupt posterior tibial translation (such as dashboard impact), falls in hyperflexion and direct hyperextension trauma are the most frequent mechanisms of production.The anterolateral bundle represents two-thirds of PCL mass and is reconstructed in single-bundle techniques.The PCL has an intrinsic capability for healing. This is the reason why, nowadays, the majority of isolated PCL tears are managed non-operatively, with rehabilitation and bracing...
April 2017: EFORT Open Rev
https://www.readbyqxmd.com/read/28499343/knee-loading-deficits-during-dynamic-tasks-in-individuals-following-acl-reconstruction
#5
Kristamarie A Pratt, Susan M Sigward
Study Design Controlled laboratory study, cross-sectional. Background Well documented deficits in sagittal plane knee loading, during dynamic tasks indicate individuals limit the magnitude of knee loading following anterior cruciate ligament reconstruction (ACLR). It is unknown how these individuals modulate the speed of knee flexion during loading, which is particularly important as they progress to running during rehabilitation. Objective To investigate how individuals following anterior cruciate ligament reconstruction perform dynamic knee loading tasks compared to healthy controls...
May 12, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28461919/anterior-cruciate-ligament-reconstruction-principles-of-treatment
#6
REVIEW
Nikolaos K Paschos, Stephen M Howell
Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in sports medicine. Several areas of controversy exist in ACL tear management which have engaged surgeons and researchers in debates towards identifying an ideal approach for these patients.This instructional review discusses the principles of ACL reconstruction in an attempt to provide guidelines and initiate a critical thinking approach on the most common areas of controversy regarding ACL reconstruction.Using high-level evidence from the literature, as presented in randomised controlled trials, systematic reviews, and meta-analyses, operative versus conservative treatment, timing of surgery, and rehabilitation are discussed...
November 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28459885/a-statistically-compiled-test-battery-for-feasible-evaluation-of-knee-function-after-rupture-of-the-anterior-cruciate-ligament-derived-from-long-term-follow-up-data
#7
Lina Schelin, Eva Tengman, Patrik Ryden, Charlotte Häger
PURPOSE: Clinical test batteries for evaluation of knee function after injury to the Anterior Cruciate Ligament (ACL) should be valid and feasible, while reliably capturing the outcome of rehabilitation. There is currently a lack of consensus as to which of the many available assessment tools for knee function that should be included. The present aim was to use a statistical approach to investigate the contribution of frequently used tests to avoid redundancy, and filter them down to a proposed comprehensive and yet feasible test battery for long-term evaluation after ACL injury...
2017: PloS One
https://www.readbyqxmd.com/read/28457606/combined-measurement-and-modeling-of-specimen-specific-knee-mechanics-for-healthy-and-acl-deficient-conditions
#8
Azhar A Ali, Michael D Harris, Sami Shalhoub, Lorin P Maletsky, Paul J Rullkoetter, Kevin B Shelburne
Quantifying the mechanical environment at the knee is crucial for developing successful rehabilitation and surgical protocols. Computational models have been developed to complement in vitro studies, but are typically created to represent healthy conditions, and may not be useful in modeling pathology and repair. Thus, the objective of this study was to create finite element (FE) models of the natural knee, including specimen-specific tibiofemoral (TF) and patellofemoral (PF) soft tissue structures, and to evaluate joint mechanics in intact and ACL-deficient conditions...
April 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28451617/return-to-sport-for-skeletally-immature-athletes-after-acl-reconstruction-preventing-a-second-injury-using-a-quality-of-movement-assessment-and-quantitative-measures-to-address-modifiable-risk-factors
#9
Jessica Graziano, Theresa Chiaia, Polly de Mille, Danyal H Nawabi, Daniel W Green, Frank A Cordasco
BACKGROUND: Reinjury rates after anterior cruciate ligament reconstruction (ACLR) are highest among young athletes, who consequently suffer from low rates of return to play. Historically, quantitative measures have been used to determine readiness to return to sport; however, they do not assess modifiable risk factors related to the quality of movement. PURPOSE: To determine the effectiveness of a criteria-based rehabilitation progression and return-to-sport criteria on efficient return to activity and prevention of second injury in young athletes post-ACLR...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28445290/efficacy-of-quadriceps-vastus-medialis-dry-needling-in-a-rehabilitation-protocol-after-surgical-reconstruction-of-complete-anterior-cruciate-ligament-rupture
#10
Jorge Velázquez-Saornil, Beatriz Ruíz-Ruíz, David Rodríguez-Sanz, Carlos Romero-Morales, Daniel López-López, Cesar Calvo-Lobo
BACKGROUND: Several new rehabilitation modalities have been proposed after anterior cruciate ligament (ACL) reconstruction. Among these, trigger point dry needling (TrP-DN) might be useful in the treatment of myofascial pain syndrome associated with ACL reconstruction to reduce pain intensity, increase knee flexion range and modify the mechanical properties of the quadriceps muscle during late-stage rehabilitation. To date, this is the first randomized clinical trial to support the use of TrP-DN in the early rehabilitation process after ACL reconstruction...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420082/can-early-rehabilitation-prevent-posttraumatic-osteoarthritis-in-the-patellofemoral-joint-after-anterior-cruciate-ligament-rupture-understanding-the-pathological-features
#11
Nai-Jen Chang, Ming-You Shie, Kuan-Wei Lee, Pei-Hsi Chou, Chih-Chan Lin, Chih-Jou Chu
Knee instability resulting from anterior cruciate ligament (ACL) rupture is a high-risk factor for posttraumatic osteoarthritis (PTOA) in the patellofemoral joint (PFJ). However, whether non-weight-bearing and weight-bearing treatments have chondroprotective effects remains unclear. Twenty-four adult New Zealand White male rabbits were employed in this study. All animals received ACL transection in the right knee and sham surgery in the left knee. The rabbits were randomly assigned to the following groups: (I) In the sedentary (SED) group, the rabbits (n = 6) were simply kept in their cage; (II) In the continuous passive motion (CPM) group, the rabbits (n = 6) performed CPM exercise for 7 days, starting from the first postoperative day; (III) In the active treadmill exercise (TRE) group, the rabbits (n = 6) performed TRE for 2 weeks; (IV) In the CPM + TRE group, the rabbits (n = 6) executed CPM exercise, followed by TRE...
April 14, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28387150/improving-acl-reconstruction-outcomes
#12
Kevin E Wilk, Kurt P Spindler, Eric McCarty, Dustin Grooms, Karin Grävare Silbernagel
Anterior cruciate ligament (ACL) reconstruction is a common and predominantly successful surgical intervention. But are there specific preoperative patient characteristics or intraoperative surgeon decisions that lead to better or worse outcomes? And can understanding brain function changes of patients after ACL reconstruction reveal insights into the ways that postsurgical rehabilitation can be improved to further enhance outcomes? These intriguing and clinically applicable questions are addressed in this webinar titled "Improving ACL Reconstruction Outcomes," hosted jointly by JOSPT and JBJS...
March 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28365070/clinical-outcome-of-primary-medial-collateral-ligament-posteromedial-corner-repair-with-or-without-staged-anterior-cruciate-ligament-reconstruction
#13
Vivek Pandey, Vikrant Khanna, Sandesh Madi, Anshul Tripathi, Kiran Acharya
INTRODUCTION: Medial collateral ligament (MCL) is a prime valgus stabilizer of the knee, and MCL tears are currently managed conservatively. However, posteromedial corner (PMC) injury along with MCL tear is not same as isolated MCL tear and the former is more serious injury and requires operative attention. However, literature is scarce about the management and outcome of PMC-MCL tear alongside anterior cruciate ligament (ACL) tear. The purpose of this study is to report the clinical outcome of primary repair of MCL and PMC with or without staged ACL reconstruction...
March 22, 2017: Injury
https://www.readbyqxmd.com/read/28361285/evaluation-of-lower-limb-kinetics-during-gait-sprint-and-hop-tests-before-and-after-anterior-cruciate-ligament-reconstruction
#14
Joaquín Moya-Angeler, Javier Vaquero, Francisco Forriol
BACKGROUND: The purpose of this study was to evaluate the functional status prior to and at different times after anterior cruciate ligament reconstruction (ACLR), and to analyze the changes in the kinetic patterns of the involved and uninvolved lower limb during gait, sprint and three hop tests. MATERIALS AND METHODS: Seventy-four male patients with an ACL injury were included in the study. All patients performed a standardized kinetic protocol including gait, sprint and three hop tests (single-leg hop, drop vertical jump and vertical jump tests), preoperatively and at 3, 6, and 12 months after ACLR with a semitendinosus gracilis tendon autograft...
March 30, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28359669/anatomic-anterior-cruciate-ligament-reconstruction-via-independent-tunnel-drilling-a-systematic-review-of-randomized-controlled-trials-comparing-patellar-tendon-and-hamstring-autografts
#15
REVIEW
Michael C Ciccotti, Eric Secrist, Fotios Tjoumakaris, Michael G Ciccotti, Kevin B Freedman
PURPOSE: To collect the highest level of evidence comparing anatomic anterior cruciate ligament (ACL) reconstruction via independent tunnel drilling using bone-patellar tendon-bone (BTB) and hamstring tendon (HT) autografts in terms of clinical outcome and failure rate. METHODS: We performed a systematic review of clinical trials that randomized patients to ACL reconstruction with either BTB or HT autografts with a minimum 2-year follow-up. Only trials using independent tunnel drilling, including outside-in and anteromedial portal techniques, for both autografts were eligible for inclusion, whereas all transtibial studies were excluded...
May 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28324994/co-activation-periods-of-gastrocnemius-and-vastus-lateralis-during-walking-evaluated-by-surface-electromyography
#16
Alessandro Mengarelli, Annachiara Strazza, Agnese Sbrollini, Angela Agostinelli, Laura Burattini, Sandro Fioretti, Francesco Di Nardo
"In vivo" studies reported that the co-activation of gastrocnemius and quadriceps femoris (QF) muscles produces ACL strain values greater than those caused by an isolated activation of either muscle. Aim of this study was to assess the co-activation of gastrocnemius (lateral head, GL) and vastus lateralis (VL) in healthy and young adults during walking. To this purpose the Statistical Gait Analysis was performed, that allows a characterization of gait considering hundreds of strides belonging to the same walking trial...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28303744/tibial-fixation-in-anterior-cruciate-ligament-reconstruction
#17
Wei Wen Timothy Teo, Ching Sing Nicholas Yeoh, Teck Huat Andy Wee
OBJECTIVE: To determine whether supplementary tibial graft fixation with a staple is routinely necessary for anterior cruciate ligament (ACL) reconstructions. METHODS: We retrospectively reviewed a series of consecutive patients who underwent ACL reconstruction at our institution from April 2012 to July 2013. Patients who fulfilled the inclusion and exclusion criteria were divided into two groups, of which one with tibial fixation of the graft with a biointerference screw alone (biointerference screw group) and the other with tibial fixation of the graft with a biointerference screw and supplementary extra tunnel staple fixation (biointerference screw and staple group)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28298052/allograft-augmentation-of-hamstring-autograft-for-younger-patients-undergoing-anterior-cruciate-ligament-reconstruction
#18
Cale A Jacobs, Jeremy M Burnham, Eric Makhni, Chaitu S Malempati, Eric Swart, Darren L Johnson
BACKGROUND: Younger patients and those with smaller hamstring autograft diameters have been shown to be at significantly greater risk of graft failure after anterior cruciate ligament (ACL) reconstruction. To date, there is no information in the literature about the clinical success and/or cost-effectiveness of increasing graft diameter by augmenting with semitendinosus allograft tissue for younger patients. HYPOTHESIS: Hybrid hamstring grafts are a cost-effective treatment option because of a reduced rate of graft failure...
March 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28267929/corrigendum
#19
(no author information available yet)
Failla MJ, Logerstedt DS, Grindem H, et al. Does extended pre-operative rehabilitation influence outcomes 2 years after ACL reconstruction? A comparative effectiveness study between MOON and Delaware-Oslo ACL cohorts. Am J Sports Med. 2016;44(10):2608-2614. (Original DOI: 10.1177/0363546516652594 ).
April 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28259850/blood-flow-restriction-training-in-clinical-musculoskeletal-rehabilitation-a-systematic-review-and-meta-analysis
#20
REVIEW
Luke Hughes, Bruce Paton, Ben Rosenblatt, Conor Gissane, Stephen David Patterson
BACKGROUND AND OBJECTIVE: Low-load exercise training with blood flow restriction (BFR) can increase muscle strength and may offer an effective clinical musculoskeletal (MSK) rehabilitation tool. The aim of this review was to systematically analyse the evidence regarding the effectiveness of this novel training modality in clinical MSK rehabilitation. DESIGN: This is a systematic review and meta-analysis of peer-reviewed literature examining BFR training in clinical MSK rehabilitation (Research Registry; researchregistry91)...
March 4, 2017: British Journal of Sports Medicine
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