RETURN TO SPORTS AFTER ACL RECONSTRUCTION (ACLR) IN THE PAEDIATRIC POPULATION: COMPARISON OF FUNCTIONAL TESTING BETWEEN A NORMATIVE POPULATION AND AN ACLR COHORT

The Knee ◽  
2020 ◽  
Vol 27 ◽  
pp. S11
Author(s):  
A. Nicholls ◽  
J. Lee ◽  
D. Myat ◽  
Y. Lim ◽  
Q. Dao
Keyword(s):  
Acl Reconstruction ◽  
Paediatric Population ◽  
Return To Sports ◽  
Functional Testing ◽  
Normative Population ◽  
Population Comparison

scholarly journals Improving the ACL-RSI: effect of motion and force analysis during Return-to-sports test 3 months after ACL reconstruction

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0054
Author(s):  
Shozaburo Terai ◽  
Christian Zantop ◽  
Thore Zantop
Keyword(s):  
Functional Analysis ◽  
Acl Reconstruction ◽  
Motion Analysis ◽  
Baseline Data ◽  
Return To Play ◽  
Isokinetic Strength ◽  
Return To Sports ◽  
Functional Testing ◽  
3D Motion ◽  
3D Motion Analysis

Introduction: Psychological factors influencing the “return to play” fate of patients following ACL reconstruction are assessed using the ACL-Return to Sports after Injury Scale (ACL-RSI). A mean of 70 points distinguishes if the patients is likely to go back to training (Webster Feller 2018). Strategies of increasing this score hves not been reported yet. Aim of this study was to compare the ACL-RSI of patients three months after ACL reconstruction before and after a multifactorial “return-to-sports” test at our institution. Our hypothesis was that the “return-to-sports” test will increase the ACL-RSI value at three months after surgery. Hypotheses: We hypothesized that following a multi-factorial testing analysis, the LSI will increase compared to the value of the RSI score before testing. Methods: A total of 102 Patients undergoing ACL reconstruction are prospectively evaluated using the ACL-RSI at baseline data prior to surgery. ACL reconstructions were performed by a single surgeon with semitendinosus graft and standardized rehabilitation protocol. Follow-up was performed at 12 weeks postoperatively using a functional analysis including isokinetic strength measurements (BTE-primus), proprioceptive tests (MTF tests) and a 3d-motion analysis (myomotion, Noraxon) during bilateral drop jumps and single leg hop tests. To evaluate the effect of this testing battery on the ACL-RSI, the scale was assessed prior to “return-to-sports” test and after the test (n=80 at abstract submission). Results: Patients showed significantly improved ACL-RSI scale values at 3 months when compared to the baseline data prior to surgery. Using a cut-off of 70 points, 25% of the patients were determined under this cut-off. ACL reconstructed patients having a high value showed a lower increase in ACL-RSI at 3 months postoperatively when the value prior to the multifactorial “return-to-sport” test is compared to after test. Patients below 70 points before the functional testing (pre: 45,23 +/-11,5) showed after the test a value of 79,15 (+/-8,3) and an increase of 33,9 points. Compared to patients higher than 70 points prior to functional testing (pre: 71,4 +/-6,4; post 78,5 +/-8,3; increase 4,4) this increase is significantly lower. The was a high correlation of patients revealing better functional results in the functional analysis (isokinetic strength, proprioceptive test and a 3d-motion analysis) and a high score in the ACL-RSI scale. Conclusion: This prospective analysis of patients following semitendinosus ACL reconstruction with one single surgeon implicates that the use of a multifactorial “return-to-sports” analysis at 3 months postoperatively is able to improve the ACL-RSI score. Interestingly, the increase in the score was significantly higher in patients having a lower baseline and prior to test score when compared to patients showing a score that is more than 70 points. The effects of this elevated score over time remains unclear and needs to investigate in subsequent studies.

scholarly journals HOP TEST AS A TOOL FOR THE ASSESSMENT AND PREVENTION OF INJURIES IN FOOTBALLERS DURING PRESEASON

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
F García-Bol ◽  
V Posada-Franco ◽  
A Roldán-Valero ◽  
R Del Caño-Espinel
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Reference Values ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Performance Criteria ◽  
Return To Sports ◽  
Hop Tests ◽  
Hop Test ◽  
Anterior Cruciate

Hop Tests (unipodal horizontal jumps) have been recommended as one of the reliable assessment tests when allowing a return to competition for a sportsperson after an anterior cruciate ligament injury1,2,3,4. Currently, comparison is made of the results with the contralateral limb through the symmetry index, a method which might not provide sufficient security upon the return to competitive sport5. Hop tests can be used in preseason to gain reference values prior to a possible injury. The objective of this review is to analise the scientific literature such as the F-Marc6 (reference manual of FIFA) to confirm whether include said tests in preseason for football teams. A search was conducted in the Pubmed y Cochrane databases (17/04/17) with the search terms “Hop Test”, “Football”, “Soccer”, and “Preseason”. Articles in English and Spanish were both accepted. Articles excluded were those that did not make reference to the knee, to football, and those that did not conduct tests during preseason. From a total of 33 articles, 4 with these search criteria were included, 5 articles were added trough the bibliography of other studies, and the F-Marc manual was analised. 4 of the articles used the hop tests in preseason for some type of study, of which 3 were used as part of a prospective assessment for the season. On the other hand, the F-Marc does not consider Hop Tests as an assessment test. Hop tests were not found to be used in preseason as reference values prior to possible future injuries, data which could be beneficial for a safe return to sport. Harris J, Abrams G, Bach B, Williams D, Heidloff D, Bush-Joseph C, Verma N, Forsythe B, Cole B. Return to Sport After ACL Reconstruction. ORTHOPEDICS. 2014; 37: e103-e108. Barber-Westin SD, Noyes FR. Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. Arthroscopy. 2011 Dec;27(12):1697-705. Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, Tsepis E, Werner S, Wondrasch B, Witvrouw E. Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2011 Nov;19(11):1798-805. Bolgla LA, Keskula DR. Reliability of lower extremity functional performance tests. J Orthop Sports Phys Ther. 1997 Sep;26(3):138-42. Wellsandt E, Failla MJ, Snyder-Mackler L. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury. J Orthop Sports Phys Ther. 2017 Mar 29:1-18. F-MARC. Football Medicine Manual. 2nd Edition. Available from: http://f-marc.com . 2017.

scholarly journals Factors Associated With Psychological Readiness to Return to Sports With Cutting, Pivoting, and Jump-Landings After Primary ACL Reconstruction

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096448
Author(s):  
Junya Aizawa ◽  
Kenji Hirohata ◽  
Shunsuke Ohji ◽  
Takehiro Ohmi ◽  
Hideyuki Koga ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Regression Analysis ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Return To Sports ◽  
Factors Associated ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction ◽  
Jump Landings

Background: High psychological readiness is an important element for returning to sports after anterior cruciate ligament (ACL) reconstruction. Identifying factors that contribute to psychological readiness is essential for planning interventions to return to play. No studies have used multivariate analysis to clarify factors associated with psychological readiness to return to specific sports. Hypothesis: To identify factors that contribute to an athlete’s psychological readiness to return after ACL reconstruction to sports that require cutting, pivoting, and jump-landings. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants were athletes who before injury had participated in sports with limited contact that required cutting, pivoting, and jump-landings (basketball, soccer, futsal, volleyball, badminton, tennis, and frisbee) and hoped to return to the same sport after reconstruction. Psychological readiness was measured using the Anterior Cruciate Ligament–Return to Sport After Injury Scale (ACL-RSI) in athletes more than 6 months after primary ACL reconstruction. To clarify factors associated with the ACL-RSI, univariate regression analysis and multivariate regression analysis were performed using the following independent variables: age, sex, body mass index, time from injury to reconstruction, time from reconstruction to testing, meniscal surgery, modified Tegner activity scale before injury, kinesiophobia, limb symmetry index of knee strength, limb symmetry indices of single-leg hop (SLH) distances, and subjective running ability. Results: Higher subjective running ability, a lower kinesiophobia score, and greater limb symmetry in the lateral SLH were positively associated with psychological readiness. Conclusion: The psychological readiness of athletes aiming to return after ACL reconstruction to limited-contact sports that require cutting, pivoting, and jump-landings was affected by subjective running ability, kinesiophobia, and asymmetry of lateral SLH distance. This information may be useful in planning appropriate interventions and thereby increasing the likelihood of an athlete’s returning to such sports.

Return to Sports after Anterior Cruciate Ligament Injury: a Matched-Pair Analysis of Repair with Internal Brace and Reconstruction Using Hamstring or Quadriceps Tendons

2020 ◽  
Author(s):  
Reinhold Ortmaier ◽  
Christian Fink ◽  
Wolfgang Schobersberger ◽  
Harald Kindermann ◽  
Iris Leister ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Quadriceps Tendon ◽  
Well Being ◽  
Matched Pair ◽  
Return To Sports ◽  
Acl Repair ◽  
Sports Activity ◽  
Matched Pair Analysis ◽  
Internal Brace

Abstract Purpose The purpose of this study was to evaluate sports activity before anterior cruciate ligament (ACL) injury and after surgical treatment of ACL rupture comparing ACL repair with an Internal Brace to ACL reconstruction using either a hamstring (HT) or quadriceps tendon (QT) autograft. Methods Between 12/2015 and 10/2016, we recruited 69 patients with a mean age of 33.4 years for a matched-pair analysis. Twenty-four patients who underwent Internal Brace reconstruction were matched according to age (± 5 years), gender, Tegner activity scale (± 1), BMI (± 1) and concomitant injuries with 25 patients who had undergone HT reconstruction and 20 patients who had undergone QT reconstruction. The minimum follow-up was 12 months. Results Overall, the return-to-sports rate was 91.3 %. There were no significant differences (p ≥ 0.05) in the number of sports disciplines and the time before return to sports within or among the groups. Overall and within the groups, the level of sports participation did not change significantly (p ≥ 0.05) postoperatively. The patients' sense of well-being was excellent after either ACL repair with an Internal Brace or ACL reconstruction with autologous HT or QT. Conclusion At short-term follow-up, ACL repair using an Internal Brace enables sports activity and provides a sense of well-being similar to that of classic ACL reconstruction using hamstring or quadriceps tendon autografts in a selected patient population. Level of Evidence: Level III Retrospective comparative study.

scholarly journals The effect of combined cryotherapy/compression versus cryotherapy following ACL reconstruction with regard to return-to-sports 3 months after surgery

2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0032
Author(s):  
Thore Zantop ◽  
Christian Zantop ◽  
Anja Hönninger ◽  
Dominik Hauner ◽  
Przemyslaw Warminski
Keyword(s):  
Acl Reconstruction ◽  
Motion Analysis ◽  
Patient Outcomes ◽  
Isokinetic Strength ◽  
Return To Sports ◽  
3D Motion ◽  
Compression Device ◽  
3D Motion Analysis ◽  
Group 2 ◽  
Group 1

Aims and Objectives: Morbidity following ACL reconstruction may be a key factor to reduce muscular dysfunction and increase physical activity. While intra-operative factors have been the focus of standardization within the last years, strategies reducing the morbidity such as postoperative cryotherapy have been investigated less. Goal of this study was to compare subjective and objective patient outcomes following ACL reconstruction with combined compression and cryotherapy compared with traditional ice therapy alone. We hypothesized that ryotherapy/compression will show significantly better results three months after ACL reconstruction compared to cryotherapy alone. Materials and Methods: A total of 40 Patients undergoing ACL reconstruction are prospectively randomized to be treated with cryotherapy/compression device (GameReady, CA/USA, group 1) or a cryotherapy device (Aircast Cryocuff, DJO CA/USA, group 2). ACL reconstructions were performed by a single surgeon with semitendinosus graft and standardized rehabilitation protocol. Patients were instructed to use the ice therapy devices 4 times per day for 30min. Pain management directly postoperatively was analyzed as recorded during clinical records and VAS. Follow-up was performed at 12 weeks postoperatively using visual analog scale (VAS), Lysholm knee score, Short Form 36 (SF36), and Tegner acitiy score. Additionally, a functional “return-to-sports” analysis including isokinetic strength measurements (BTE-primus), proprioceptive tests (MTF tests) and a 3d-motion analysis (myomotion, Noraxon) during bilateral drop jumps and single leg hop tests was performed. Results: VAS and comparison of the administrated painkillers showed no significant differences between the two groups. Both groups used the cryotherapy/compression device and the cryotherapy device as determined by the study protocol. At 12 weeks, there was no significant difference between the two groups with regard to Lysholm score, Tegner score, and SF-36, however there was a trend towards better scores in group 1. The was a higher range of motion in group 1 compared to group 2. Functional analysis with isokinetic strength measurements, proprioceptive test and a 3d-motion analysis revealed better functional results in patients of the group cryotherapy/compression device compared to cryotherapy alone. Conclusion: This prospective analysis of 40 patients following semitendinosus ACL reconstruction with one single surgeon implicates that the use of a cryotherapy/compression device (GameReady) showed significantly better objective patient outcomes following ACL reconstruction compared to cryotherapy alone.

scholarly journals Functional outcome in patients following cartilage regeneration outcome at minimum follow-up of 12 months

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0054
Author(s):  
Christian Liefke ◽  
Christian Zantop ◽  
Shozaburo Terai ◽  
Thore Zantop
Keyword(s):  
Functional Analysis ◽  
Acl Reconstruction ◽  
Functional Results ◽  
Return To Play ◽  
Isokinetic Strength ◽  
Return To Sports ◽  
Recurrent Instability ◽  
3D Motion Analysis ◽  
Return To Competition

Introduction: Several studies have focused on the return to play rate after ACL reconstruction. Whereas most studies just report the rate as a result, only few studies evaluate specific parameters and tests to further investigate the conditions of when the patients should return to sports. Hypotheses: Aim of this study was to compare the return to competition rate of patients 12 months after ACL reconstruction and correlate the rate and re-rupture fate to the assessed multifactorial “return-to-sports” test 3 months after ACL reconstruction at our institution. Methods: A total of 51 Patients undergoing ACL reconstruction are prospectively evaluated using a “return-to-sports” test 3 months following ACL reconstruction. Inclusion criteria was isolated ACL rupture, Level 1 sports participation, free range of motion at FU 3 months, age >18 and <50, no associated ligamentous or meniscal injury influencing the rehab protocol and intact contralateral leg. ACL reconstructions were performed by a single surgeon with semitendinosus graft and standardized rehabilitation protocol. Follow-up at 3 months postoperatively was performed using a functional analysis including isokinetic strength measurements (BTE-primus), proprioceptive tests (MTF tests) and a 3d-motion analysis (myomotion, Noraxon) during bilateral drop jumps and single leg hop tests. To evaluate the return to play rate and recurrent instability problems a survey was used at timepoint 12 months postoperatively (n=43 at abstract submission). Results: At timepoint 12 months following ACL reconstruction 6 of 43 currently evaluated patients did not return to competition (6/43). A total of 5 patients were evaluated as moderate to high risk for ACL recurrent instability in the return-to-sports analysis at three months whereas one patient not returning to competition showed a not elevated risk for ACL recurrent instability in the analysis. The was a high correlation of patients revealing better functional results in the functional analysis (isokinetic strength, proprioceptive test and a 3d-motion analysis) and returning to sports. A total of 8 patients (4/43) suffered a recurrent instability after returning to sports. Conclusion: This prospective analysis of patients following semitendinosus ACL reconstruction with one single surgeon implicates that the rate of returning to sports in patients using a multifactorial “return-to-sports” analysis at 3 months postoperatively is higher compared to the rate of patients without such an analysis in the literature. We found a high correlation between better functional results and return to play rate as well as a re-rupture rate of 10% in patients after returning to sports.

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