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anterior cruciate ligament rehabilitation

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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/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
#7
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
#8
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
#9
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/28417093/instability-resistance-training-for-health-and-performance
#10
REVIEW
Erika Zemková
Recently, resistance exercises performed on an unstable surface have become part of athletic training and rehabilitation. Accordingly, their role in performance and health-oriented strength training has increasingly emerged as a matter of interest to researchers and conditioning specialists. A more pronounced activation of stabilizing muscles is assumed to be the main feature of instability resistance exercises. This assumption has been proven by EMG studies, which have highlighted significantly greater electromyographic activity of trunk-stabilizing muscles during exercises under unstable as compared to stable conditions...
April 2017: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/28387150/improving-acl-reconstruction-outcomes
#11
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/28378137/hip-external-rotation-strength-predicts-hop-performance-after-anterior-cruciate-ligament-reconstruction
#12
Paul W Kline, Jeremy Burnham, Michael Yonz, Darren Johnson, Mary Lloyd Ireland, Brian Noehren
PURPOSE: Quadriceps strength and single-leg hop performance are commonly evaluated prior to return to sport after anterior cruciate ligament reconstruction (ACLR). However, few studies have documented potential hip strength deficits after ACLR, or ascertained the relative contribution of quadriceps and hip strength to hop performance. METHODS: Patients cleared for return to sports drills after ACLR were compared to a control group. Participants' peak isometric knee extension, hip abduction, hip extension, and hip external rotation (HER) strength were measured...
April 4, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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...
June 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/28355976/on-ice-return-to-hockey-progression-after-anterior-cruciate-ligament-reconstruction
#16
Jacob J Capin, William Behrns, Karen Thatcher, Amelia Arundale, Angela Hutchinson Smith, Lynn Snyder-Mackler
Synopsis Limited literature exists pertaining to rehabilitation of ice hockey players seeking to return-to-sport after anterior cruciate ligament reconstruction (ACLR). The purpose of this clinical commentary is to present a criterion-based, return-to-ice hockey progression for athletes after ACLR. First, we review pertinent literature and provide previously published guidelines on general rehabilitation after ACLR. Then, we present a four-phase, on-ice skating progression with objective criteria to initiate each phase...
March 29, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28324994/co-activation-periods-of-gastrocnemius-and-vastus-lateralis-during-walking-evaluated-by-surface-electromyography
#17
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
#18
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
#19
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/28259710/no-beneficial-effect-of-bracing-after-anterior-cruciate-ligament-reconstruction-in-a-cohort-of-969-athletes-followed-in-rehabilitation
#20
P Bordes, E Laboute, A Bertolotti, J F Dalmay, P Puig, P Trouve, E Verhaegue, P A Joseph, P Dehail, M De Seze
OBJECTIVE: Compare the clinical outcomes of different knee braces in the early phase of rehabilitation after anterior cruciate ligament reconstruction (ACLR) in athletes. MATERIALS AND METHODS: We conducted a retrospective database study of athletes during early rehabilitation in a tertiary referral hospital between 1 February 2008 and 30 October 2010 after ACLR using bone patellar tendon bone (BPTB) or hamstring autograft. Differences in mid-patellar knee circumference, pain, and range of motion were assessed at admission...
March 1, 2017: Annals of Physical and Rehabilitation Medicine
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