scholarly journals Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Allograft in Patients Aged 50 and Older Leads to Improved Activity Levels and Acceptable Patient-Reported Outcomes

2021 ◽  
Author(s):  
Stephen M. Sylvia ◽  
Thomas J. Gill ◽  
Ian D. Engler ◽  
Kaitlin M. Carroll ◽  
Matthew J. Salzler
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patient Reported Outcomes ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Bone Allograft ◽  
Activity Levels ◽  
Cruciate Ligament Reconstruction ◽  
Patient Reported ◽  
Anterior Cruciate ◽  
Bone Patellar Tendon

Effect of Physical Therapy Visits on Clinical Outcomes Following Anterior Cruciate Ligament Reconstruction With and Without Concurrent Meniscal Repair

2019 ◽  
Vol 28 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Jesse C. Christensen ◽  
Caitlin J. Miller ◽  
Ryan D. Burns ◽  
Hugh S. West
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patient Reported Outcomes ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Patient Reported Outcome ◽  
Younger Patients ◽  
Cruciate Ligament Reconstruction ◽  
Patient Reported ◽  
Anterior Cruciate

Background:Health care payment reform has increased employers and health insurance companies’ incentive to take measures to control the rising costs of medical care in the United States. To date, limited research has investigated the influence outpatient physical therapy (PT) visits have on clinical outcomes following anterior cruciate ligament reconstruction (ACLR) with and without a concurrent meniscal repair.Objective:To examine the relationship between the number of PT visits and patient-reported outcome scores following ACLR outpatient rehabilitation.Study Design:Retrospective cohort.Level of Evidence:2b.Methods:Patients following ACLR with (n = 62) and without (n = 328) meniscal repair were identified through an electronic medical record database.Results:Patients with more PT visits had higher knee outcome survey—activities of daily living (KOS-ADL) change scores (P = .01) following ACLR without meniscal repair. Younger patients yielded significantly higher KOS-ADL change scores (P = .05) in the same cohort. Patients in the semisupervised PT visit strata recorded an 11.1 higher KOS-ADL change score compared with patients within the unsupervised PT visit stratum (P = .02). Younger patients also yielded significantly larger reductions in numeric pain (P = .01) following ACLR without meniscal repair. No significant differences were found between PT visits and either patient-reported outcome following ACLR with meniscal repair.Conclusions:Our findings suggest that younger patients and those in a semisupervised PT visit model have superior patient-reported outcomes following ACLR without meniscal repair. Preliminary findings indicate no relationship with PT visits and patient-reported outcomes in patients after ACLR with meniscal repair surgery.Clinical Relevance:These findings promote an alternative model to outpatient PT following ACLR without meniscal repair that may be more clinically effective and value based. There appears to be a need for patients to undergo a balanced regimen of supervised PT and effective interventions that can be conducted independently.

scholarly journals Changes in Infrapatellar Fat Pad Volume From 6 to 12 months Following Anterior Cruciate Ligament Reconstruction and Associations with Patient-Reported Knee Function

2021 ◽  
Author(s):  
Kyle G. Wallace ◽  
Steven J. Pfeiffer ◽  
Laura S. Pietrosimone ◽  
Matthew S. Harkey ◽  
Xiaopeng Zong ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Patient Reported Outcomes ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Infrapatellar Fat Pad ◽  
Fat Pad ◽  
Cruciate Ligament Reconstruction ◽  
Patient Reported ◽  
Anterior Cruciate

Context: Hypertrophy of the Infrapatellar Fat Pad (IFP) in idiopathic knee osteoarthritis has been linked to deleterious synovial changes and joint pain related to mechanical tissue impingement; yet, little is known regarding the IFP's volumetric changes following anterior cruciate ligament reconstruction (ACLR). Objective: To examine changes in IFP volume between 6 and 12 months following ACLR and determine associations between patient-reported outcomes and IFP volume at each time point, as well as volume change over time. In a subset of individuals, we examined inter-limb IFP volume differences 12 months post-ACLR. Study Design: Prospective cohort study Setting: Laboratory Patients or Other Participants: We included 26 participants (13 females, 13 males, 21.88±3.58 years, 23.82±2.21 kg/m2) for our primary aims and 13 of those participants (8 females, 5 males, 21.15±3.85 years, 23.01±2.01 kg/m2) for our exploratory aim. Main Outcome Measure(s): Using magnetic resonance imaging, we evaluated IFP volume change between 6 and 12 months post-ACLR in the ACLR limb and between-limb differences at 12 months in a subset of participants. International Knee Documentation Committee subjective knee evaluation (IKDC) scores were collected at 6-month and 12-month follow-ups and associations between IFP volume and patient-reported outcomes were determined. Results: IFP volume in the ACLR limb significantly increased from 6 (19.67±6.30 cm3) to 12 (21.26±6.91 cm3) months post-ACLR. Greater increases of IFP volume between 6 and 12 months significantly associated with better 6-month IKDC scores (r=0.44, P=0.03). IFP volume was significantly greater in the uninjured limb (22.71±7.87 cm3) compared to the ACLR limb (20.75±9.03 cm3) 12 months post-ACLR. Conclusions: IFP volume increased between 6 and 12 months post-ACLR; however, the IFP volume of the ACLR limb remained smaller than the uninjured limb at 12-months. Additionally, those with better knee function 6 months post-ACLR demonstrated greater increases in IFP volume between 6 and 12 months post-ACLR. This suggests greater IFP volumes may play a role in long-term joint health following ACLR.

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