Outcomes and Return to Sports Following the Ankle Lateral Ligament Reconstruction in Professional Athletes: A Systematic Review of the Literature

DOI: 10.15448/1980-6108.2017.1.25082Aims: The prevalence rate of ankle complexities is increasing at a constant rate among athletes. This study aimed to systematically describe the facts and findings related to the effectiveness of training programs on proprioception among athletes suffering from ankle ligament injury.Methods: A literature search in online libraries (Google Scholar, PubMed, EBSCOhost, and ProQuest) using different search engines was conducted for the systematic review and meta-analysis. The common keywords included NEUROMUSCULAR, EXERCISE, TRAINING, PROPRIOCEPTION, and ATHLETES. Studies related to the topic, having relevant resources, and published within the past 10 years were used as inclusion criteria. Methodological quality was assessed through PEDro scale. A meta-analysis of the selected trials was conducted to assess the effectiveness of intervention. Results: Two hundred research articles were initially selected. After close scrutiny, 15 articles were included. Five moderate to excellent quality trials were selected, which involved 2,459 participants. It has been mainly identified that ankle sprain and its complications can be easily prevented with the help of training programs (five trials, relative risk: 0.69, 96%CI: 0.65-0.87). A statistically significant relationship was identified among athletes regarding the preventive impacts of training on proprioception. Conclusions: Preventive training programs were helpful for athletes in terms of proprioception, thus reducing the risk of ankle sprains.

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Tourne's technique (modified) for ankle lateral ligament reconstruction

Foot and Ankle Surgery ◽

10.1016/j.fas.2017.07.251 ◽

2017 ◽

Vol 23 ◽

pp. 55

Author(s):

H. Kurup

Keyword(s):

Ligament Reconstruction ◽

Lateral Ligament ◽

Ankle Lateral Ligament

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Similar clinical outcome between patellar tendon and hamstring tendon autograft after anterior cruciate ligament reconstruction with accelerated, brace-free rehabilitation: a systematic review

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine ◽

10.1136/jisakos-2016-000110 ◽

2017 ◽

Vol 2 (6) ◽

pp. 308-317 ◽

Cited By ~ 3

Author(s):

Rob PA Janssen ◽

Nicky van Melick ◽

Jan BA van Mourik ◽

Max Reijman ◽

Lodewijk W van Rhijn

Keyword(s):

Systematic Review ◽

Anterior Cruciate Ligament ◽

Clinical Outcome ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Hamstring Tendon ◽

Return To Sports ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

ImportanceControversy exists with respect to the best graft choice for anterior cruciate ligament reconstruction (ACLR) with accelerated, brace-free rehabilitation.ObjectiveTo investigate differences in clinical outcome between patellar tendon (PT) and hamstring tendon (HS) autografts for ACLR with accelerated, brace-free rehabilitation.Evidence reviewSystematic review, all settings. Search from 1 January 1974 till 31 January 2017 in Medline (Pubmed), EMBASE (OVID), Cochrane Library and CINAHL according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. All study designs that reported clinical outcome in adults after arthroscopic, primary ACLR with accelerated, brace-free rehabilitation, HS or PT autografts were included. A risk of bias assessment of the eligible articles was determined. Data collection included surgical techniques, graft type, patient demographics, details of rehabilitation, patient-reported outcome, clinical outcome measures and radiological evaluation. A ‘best-evidence synthesis’ was performed for the formulated research questions. Eighteen studies were included.FindingsAfter autograft ACLR with accelerated, brace-free rehabilitation: (1) PT and HS autografts provide satisfactory short and long-term results in terms of range of motion, subjective stability and functional scores; (2) PT autograft is associated with more pain on kneeling and increased risk of knee osteoarthritis; (3) there is ‘conflicting’ evidence between PT and HS autografts for objective knee stability, knee laxity in females, return to sports and muscle strength; (4) there is no difference between males and females in return to sports irrespective of the chosen graft type; (5) HS autograft is correlated with tunnel widening; (6) early progressive eccentric exercises from 3 weeks postsurgery can safely be added irrespective of graft type; (7) early start of open kinetic exercises (4 weeks) causes increased laxity of HS autograft; (8) focus on quality of movement is important as part of ACL rehabilitation protocols and return to sports criteria.Conclusions and relevancePT and HS autografts may both be selected for ACLR with accelerated, brace-free rehabilitation. Specific considerations for each graft type must be made during rehabilitation. PT reconstructions are more likely to result in statically stable knees, but are also associated with more complications and osteoarthritis. There is insufficient evidence to draw conclusions on differences between PT and HS autograft for long-term outcome.Level of evidenceIII.

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Longitudinal Kinetic and Kinematic Changes in Functional Tasks After Reconstructing Anterior Cruciate Ligament: A Systematic Review

Journal of Exercise Science and Medicine ◽

10.32598/jesm.12.1.2 ◽

2020 ◽

Vol 12 (1) ◽

pp. 133-146

Author(s):

Fatemeh Sharafoddin-Shirazi ◽

◽

Amir Letafatkar ◽

Zohreh Gholami ◽

◽

...

Keyword(s):

Systematic Review ◽

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Reaction Force ◽

Return To Sports ◽

Cruciate Ligament Reconstruction ◽

Peak Knee ◽

Anterior Cruciate

Introduction: The return to sport after Anterior Cruciate Ligament Reconstruction (ACLR) is among the main issues encountered by rehabilitation medicine, injured athletes, and coaches. A main factor preventing safe return to sports is a biomechanical asymmetry between the limbs during reconstruction, which plays a significant role in the risk of re-injury. Accordingly, injury-related biomechanical changes were systematically examined in individuals with ACLR as performed functional tasks. Materials and Methods: Articles relevant to biomechanical asymmetries between (ACLR & uninjured) limbs in English were searched in the Google Scholar, Science Direct, PubMed MEDLINE, and Scopus databases without time limit until 2021, using the following keywords: “Anterior cruciate ligament reconstruction”, “ACL reconstruction”, “biomechanical”, “Kinetic”, “Kinematic”, and “Asymmetry”. Results: In total, 122 articles were found, of which 18 met the inclusion (PRISMA) criteria. Most of the kinetic and kinematic parameters were observed in the intervals of 3, 6, 9, 12, and 18 months after ACLR between the athletes’ vertical Ground Reaction Force (vGRF), peak hip abduction moment, peak knee valgus angle, peak knee flexion moment and angle, during the functional tasks; also changes were detected in the articles up to 28 months, although research in this area was limited. Conclusion: The present systematic review suggested that biomechanical variables may vary among the limbs of patients with ACLR, between 18 and over 28 months. Accordingly, an asymmetry between the limbs increases the risk of re-injury. Therefore, a better understanding of the biomechanics of the limbs in the time intervals after ACLR can provide a safer and sooner return to sports activities.

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