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ACL rehabilitation

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
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
Lei Zhang, Taiyuan Guan, Ji Qi, Shaoqun Zhang, Xin Zhou, Yang Liu, Shijie Fu
The anterior cruciate ligament (ACL) is an important structure that maintains the stability of knee joints. Animal models of ACL injury are helpful to explore its underlying mechanisms, and strategies for prevention, treatment and rehabilitation. Therefore, the aim of the present study was to develop an efficient model of ACL injury in cynomolgus monkeys via arthroscopic techniques. In the present study, 18 cynomolgus monkeys were randomly divided into a model group (n=6), a sham operation group (n=6) and a blank control group (n=6)...
March 2018: Experimental and Therapeutic Medicine
Daan T van Yperen, Max Reijman, Eline M van Es, Sita M A Bierma-Zeinstra, Duncan E Meuffels
BACKGROUND: An anterior cruciate ligament (ACL) rupture has major consequences at midterm follow-up, with an increasing chance of developing an old knee in a young patient. The long-term (≥20 years) effects of the operative and nonoperative treatment of ACL ruptures are still unclear. PURPOSE: To compare the long-term treatment outcomes of operative versus nonoperative treatment of ACL ruptures in high-level athletes. STUDY DESIGN: Cohort study; Level of evidence, 2...
February 1, 2018: American Journal of Sports Medicine
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
Hirotaka Mutsuzaki, Hiromi Nakajima, Masataka Sakane
[Purpose] To investigate the influence of knee immobilization period on recovery of histological damages in the anterior cruciate ligament (ACL) insertion and articular cartilage in rabbits. This knowledge is important for determining the appropriate rehabilitation approach for patients with ligament injuries, fracture, disuse atrophy, and degenerative joint disease. [Materials and Methods] Forty-eight male Japanese white rabbits were divided equally into the remobilization and control groups. The remobilization group had the right knee surgically immobilized, and was divided equally into four subgroups according to the duration of immobilization (1, 2, 4 and 8 weeks)...
January 2018: Journal of Physical Therapy Science
Nirav Maniar, Anthony G Schache, Prasanna Sritharan, David A Opar
Anterior cruciate ligament (ACL) injuries are a burdensome condition due to potential surgical requirements and increased risk of long term debilitation. Previous studies indicate that muscle forces play an important role in the development of ligamentous loading, yet these studies have typically used cadaveric models considering only the knee-spanning quadriceps, hamstrings and gastrocnemius muscle groups. Using a musculoskeletal modelling approach, we investigated how lower-limb muscles produce and oppose key tibiofemoral reaction forces and moments during the weight acceptance phase of unanticipated sidestep cutting...
February 6, 2018: Scientific Reports
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
Fernando M Baeder, Daniel F Silva, Ana Cl de Albuquerque, Maria Tbr Santos
Introduction: Individuals with cerebral palsy (CP) often present with oral alterations that impact oral health and require dental treatment. Aim: This study aimed to evaluate the use of conscious sedation with nitrous oxide (N2O) to control stress during dental treatment in individuals with CP using as parameters: Venham score (VS), heart rate (HR), and respiratory rate (RR). Materials and methods: A total of 77 CP patients >3 years of age with a mean age of 11...
October 2017: International Journal of Clinical Pediatric Dentistry
Derwin King Chung Chan, Alfred Sing Yeung Lee, Martin S Hagger, Kam-Ming Mok, Patrick Shu-Hang Yung
Managing rehabilitation for ACL injury is dependent on uptake of, and compliance with, medical and safety recommendations. In this paper, we propose a multi-theory model that integrates self-determination theory and the theory of planned behavior to identify the motivational determinants ACL injury prevention and management behaviors and the processes involved.
October 2017: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
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
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
Alexis Lion, Paul Gette, Christophe Meyer, Romain Seil, Daniel Theisen
Our study aimed to evaluate the effect of cognitive challenge on double-leg postural control under visual and surface perturbations of patients with anterior cruciate ligament reconstruction (ACLR) cleared to return to sport. Double-leg stance postural control of 19 rehabilitated patients with ACLR (age: 24.8 ± 6.7 years, time since surgery: 9.2 ± 1.6 months) and 21 controls (age: 24.9 ± 3.7 years) was evaluated in eight randomized situations combining two cognitive (with and without silent backward counting in steps of seven), two visual (eyes open, eyes closed) and two surface (stable support, foam support) conditions...
December 15, 2017: Gait & Posture
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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