Return to sports following arthroscopic primary repair of the anterior cruciate ligament in the adult population

The Knee ◽  
2020 ◽  
Vol 27 (3) ◽  
pp. 906-914
Author(s):  
Harmen D. Vermeijden ◽  
Jelle P. van der List ◽  
Robert O'Brien ◽  
Gregory S. DiFelice
Keyword(s):  
Anterior Cruciate Ligament ◽  
Primary Repair ◽  
Cruciate Ligament ◽  
Adult Population ◽  
Return To Sports ◽  
Anterior Cruciate

scholarly journals IS PERCUTANEOUS MEDIAL COLLATERAL LIGAMENT (MCL) RELAXATION DURING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION A SAFE OPTION FOR GAINING ACCESS TO THE MEDIAL KNEE COMPARTMENT IN CHILDREN?

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
John A. Schlechter ◽  
Tanner Harrah ◽  
Bryn Gornick ◽  
Benjamin Sherman
Keyword(s):  
Anterior Cruciate Ligament ◽  
Children And Adolescents ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Adult Population ◽  
Deep Infection ◽  
Patient Reported Outcome ◽  
Collateral Ligament ◽  
Patient Reported ◽  
Anterior Cruciate

Introduction: With participation in youth sports anterior cruciate ligament (ACL) injuries are a common occurrence. Nearly 70% of ACL tears in children and adolescents have an associated meniscus tear. Percutaneous medial collateral ligament (MCL) relaxation has been described as utilitarian in accessing the medial meniscus for diagnostic assessment and treatment in the adult population to increase medial compartment working space in arthroscopic surgery. The technique has not been evaluated in the pediatric population. The purpose of this study was to compare the outcomes of children and adolescents that underwent anterior cruciate ligament reconstruction (ACLR) with and without percutaneous relaxation of the medial collateral ligament (MCL) for meniscal tear management. Methods: A retrospective review was performed of patients aged 8 to 19 years old that had undergone knee arthroscopy for an (ACLR) with meniscus pathology. Those that underwent MCL relaxation were grouped together and compared to a matched cohort that did not have MCL relaxation performed. Preoperative, operative and postoperative data was analyzed. The primary measurement was obtained using a validated patient reported outcome score (Pedi-IKDC), secondary outcome measures were defined as superficial or deep infection, saphenous nerve dysesthesias, ACL graft failure and return to the operating room. Statistical analysis of the two cohorts was performed. Results: Fifty-four patients were included in the study (27 in each group) with average age 15 years (range 10-19). Average follow-up for the MCL relaxation group was 22.4 months versus 58 months for the non-MCL relaxation group. The average Pedi-IKDC score was 93.3 for the MCL relaxation group and 91.4 for the non-MCL relaxation group (p=0.34). There was no difference in patient demographics, return to the operating room (p=0.49), saphenous nerve dysesthesia (p=0.49), superficial or deep infection (p=0.32). Conclusion: ACL reconstruction in children and adolescents with MCL relaxation for the management of medial meniscal tears appears to be a safe option. Equivocal patient reported outcome scores as compared to the control group were found with no increase in post-operative complications. In children with ACL tears, appropriate diagnosis and management of medial meniscal pathology is important to maintain secondary restraint to anterior tibial translation and prevent premature graft failure. Pediatric knees can have tight medial compartments, making access difficult, potentially leading to poor visualization and iatrogenic chondral damage. Percutaneous medial collateral ligament (MCL) relaxation has been described in the adult population to increase medial compartment working space without long term sequela. We report similar findings in an all pediatric cohort.

scholarly journals Satisfactory patient-reported outcomes at 5 years following primary repair with suture tape augmentation for proximal anterior cruciate ligament tears

2021 ◽  
Author(s):  
Graeme P. Hopper ◽  
Joanna M. S. Aithie ◽  
Joanne M. Jenkins ◽  
William T. Wilson ◽  
Gordon M. Mackay
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patient Reported Outcomes ◽  
Primary Repair ◽  
Cruciate Ligament ◽  
Acl Repair ◽  
Patient Reported ◽  
Activity Scale ◽  
Anterior Cruciate ◽  
Suture Tape

Abstract Purpose An enhanced understanding of anterior cruciate ligament (ACL) healing and advancements in arthroscopic instrumentation has resulted in a renewed interest in ACL repair. Augmentation of a ligament repair with suture tape reinforces the ligament and acts as a secondary stabilizer. This study assesses the 5-year patient-reported outcomes of primary repair with suture tape augmentation for proximal ACL tears. Methods Thirty-seven consecutive patients undergoing ACL repair with suture tape augmentation for an acute proximal rupture were prospectively followed up for a minimum of 5 years. Patients with midsubstance and distal ruptures, poor ACL tissue quality, retracted ACL remnants and multiligament injuries were excluded. Patient-reported outcome measures were collated using the Knee Injury and Osteoarthritis Outcomes Score (KOOS), Visual Analogue Pain Scale (VAS-pain), Veterans RAND 12-Item Health Survey (VR-12) and the Marx Activity Scale. Patients with a re-rupture were identified. Results Three patients were lost to follow-up leaving 34 patients in the final analysis (91.9%). The mean KOOS at 5 years was 88.5 (SD 13.8) which improved significantly from 48.7 (SD 18.3) preoperatively (p < 0.01). The VAS score improved from 2.3 (SD 1.7) to 1.0 (SD 1.5) and the VR-12 score improved from 35.9 (SD 10.3) to 52.4 (SD 5.9) at 5 years (p < 0.01). However, the Marx activity scale decreased from 12.4 (SD 3.4) pre-injury to 7.3 (SD 5.2) at 5 years (p = 0.02). Six patients had a re-rupture (17.6%) and have since undergone a conventional ACL reconstruction for their revision surgery with no issues since then. These patients were found to be younger and have higher initial Marx activity scores than the rest of the cohort (p < 0.05). Conclusion Primary repair with suture tape augmentation for proximal ACL tears demonstrates satisfactory outcomes in 28 patients (82.4%) at 5-year follow-up. Six patients sustained a re-rupture and have no ongoing problems following treatment with a conventional ACL reconstruction. These patients were significantly younger and had higher initial Marx activity scores. Level of evidence Level IV.

scholarly journals Acute effects of the Prevent injury and Enhance Performance warm-up on potential reinjury risk factors associated with unanticipated jump landings: Study protocol for a crossover randomized controlled trial in individuals cleared for return to sports after anterior cruciate ligament reconstruction.

2020 ◽  
Author(s):  
Evans Y. K. Ashigbi ◽  
Florian Giesche ◽  
Winfried Banzer ◽  
David A. Groneberg ◽  
Daniel Niederer
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Moderate Intensity ◽  
Return To Sports ◽  
Acute Effects ◽  
Warm Up ◽  
Randomized Controlled ◽  
Anterior Cruciate

Abstract BackgroundIn team-sports such as football or basketball, athletes need to rapidly adapt their motor plans and actions to unanticipated changes in the environment. Unanticipated jump-landing tasks have been found to elevate the risk of non-contact anterior cruciate ligament (ACL) injuries compared to an anticipated condition. ACL-reconstructed individuals may have greater difficulties to maintain neuromuscular control under unanticipated conditions exposing them to a higher reinjury risk during the game. The planned trial aims to investigate the acute effects of a team-sport specific injury prevention programme on potential ACL reinjury risk factors under anticipated and unanticipated jump-landings.Methods and design:Single center randomized controlled crossover trial. Female and male ACL-reconstructed participants cleared for return to sports (≥ 6 months and ≤ 24 months post-reconstruction) will be included. In a randomized sequence and with a washout phase of one week in between, the participants will perform an injury preventive warm-up protocol (PEP; strengthening, flexibility, plyometry and agility) and a standard warm-up program (bicycle ergometer). Both interventions will last for 12 minutes and will be conducted at moderate intensity (BORG scale: 12 to 14). After each warm-up, participants will perform counter movement jumps with single-leg landings on a force plate. Prior to the jump, a left or right footprint (equally distributed) will be indicated on a screen. Under the anticipated condition, the participants will be informed before the jump that the displayed footprint will not change after take-off. Under the unanticipated condition, the participants will not know whether the target landing side will remain the same (consistent with pre-movement expectations) or change (inconsistent). Under both unanticipated conditions, this information will be displayed 0.1 second after take-off and thus approximately 0.3 seconds before landing.Parametric/non-parametric crossover-analyses (carryover-tests and crossover test) for between-conditions comparisons will be applied. Trial registration: German Clinical Trials Register, identification number DRKS00016942. Registered on May 24, 2019.

scholarly journals Arabic Version of the Short Anterior Cruciate Ligament–Return to Sport After Injury Scale: Translation, Cross-cultural Adaptation, and Validation

2022 ◽  
Vol 10 (1) ◽  
pp. 232596712110665
Author(s):  
Msaad Alzhrani ◽  
Hosam Alzahrani ◽  
Yasir S. Alshehri
Keyword(s):  
Anterior Cruciate Ligament ◽  
Internal Consistency ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Short Version ◽  
Return To Sports ◽  
Strongly Correlated ◽  
Retest Reliability ◽  
Anterior Cruciate ◽  
Test Retest Reliability

Background: The short version of the Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI) scale is a self-reported questionnaire developed to assess the psychological readiness of patients to return to sports after ACL reconstruction (ACLR). Purpose: To translate, cross-culturally adapt, and validate the short version of the ACL-RSI scale into the Arabic language (ACL-RSI-Ar). Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The original short version of the ACL-RSI scale was forward and backward translated, cross-culturally adapted, and validated following international standardized guidelines. Sixty patients who participated in sports activities and underwent ACLR completed the ACL-RSI-Ar, the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and Knee injury and Osteoarthritis Outcome Score (KOOS) scales. To assess test-retest reliability, 34 participants completed the ACL-RSI-Ar scale twice. Statistical tests were conducted to test the internal consistency, reliability, and construct and discriminant validity of the ACL-RSI-Ar scale. Results: The ACL-RSI-Ar showed adequate internal consistency (Cronbach alpha = 0.734) and excellent test-retest reliability (intraclass correlation coefficient, 0.871). The ACL-RSI-Ar was strongly correlated with the IKDC (Spearman ρ = 0.515, P < .001) and weakly to strongly correlated with all KOOS subscales (Spearman ρ = 0.247-0.590, P < .05). Patients who returned to sports had significantly higher scores on the ACL-RSI-Ar scale when compared with those who did not return to sports ( P = .001). Conclusion: The short ACL-RSI-Ar scale, as translated, was internally consistent, reliable, and valid for evaluating psychological readiness to return to sports after ACLR in Arabic-speaking patients.

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