Sport-Specificity of Knee Scoring Systems to Assess Disability in Anterior Cruciate Ligament-Deficient Athletes

1998 ◽  
Vol 7 (1) ◽  
pp. 44-60 ◽  
Author(s):  
Paul A. Borsa ◽  
Scott M. Lephart ◽  
James J. Irrgang
Keyword(s):  
Anterior Cruciate Ligament ◽  
Activities Of Daily Living ◽  
Outcome Measures ◽  
Scoring System ◽  
Daily Living ◽  
Functional Disability ◽  
Cruciate Ligament ◽  
Scoring Systems ◽  
Anterior Cruciate ◽  
Acl Deficient

We compared the outcome measures of three knee scoring systems currently used to measure disability in anterior cruciate ligament (ACL)–deficient athletes. Twenty-nine ACL-deficient athletes completed three scoring systems (the Lysholm Knee Scoring System, a modified version of the Cincinnati Knee Scoring System, and the Knee Outcome Survey). Results demonstrate statistically significant mean differences and linear relationships between the outcome measures for the three scoring systems. The Knee Outcome Survey appears to provide valid measures of disability and indicates that our subjects functioned well with activities of daily living but became symptomatic and functionally limited with sports. The outcome measures also indicate that the Lysholm system is more specific to activities of daily living, while the modified Cincinnati is more specific to sports. We recommend that standard scoring systems be developed to provide measures of functional disability in athletes who experience knee injuries.

scholarly journals Neuroplasticity in Corticolimbic Brain Regions in Patients after Anterior Cruciate Ligament Reconstruction

2020 ◽  
Author(s):  
Shelby Baez ◽  
Anders Andersen ◽  
Richard Andreatta ◽  
Marc Cormier ◽  
Phillip Gribble ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Bold Signal ◽  
Cruciate Ligament Reconstruction ◽  
Echoplanar Imaging ◽  
Anterior Cruciate

ABSTRACT Context: Fear has been cited as the primary barrier for return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR). Understanding the neural factors contributing to fear after ACLR may help identify interventions for this population. Objective: The objective of this study was to characterize the underlying neural substrate of injury-related fear in patients after ACLR versus healthy matched controls during a picture imagination task (PIT) consisting of sports-specific images and activities of daily living images. Design: Case-Control Study Setting: Research Laboratory Patients or Other Participants: A total of 24 right-hand dominant participants (12 left-sided ACLR and 12 controls) were enrolled. Participants underwent full brain functional magnetic resonance imaging (fMRI). Main Outcome Measure(s): Functional data were acquired with Blood Oxygen Level Dependent (BOLD) echoplanar imaging. Independent t-tests were used to identify significant between group differences in BOLD signal changes during all images of the PIT. Paired t-tests were used to examined differences in BOLD signal change between sports-specific images and activities of daily living (ADLs) in the ACLR group. Results: Increased activation in the inferior parietal lobule (IPL) and the mediodorsal thalamus (MDT) were observed during PIT in the ACLR group. Inability to suppress the default mode network (DMN) in the ACLR group was observed. The ACLR group exhibited increased activation in the cerebellum and inferior occipital regions during the sports-specific task when compared to ADLs, but no other regions of interest demonstrated statistically significant differences. Conclusion: These findings suggest that ACLR patients may be more disposed to processing fear, anxiety, and/or pain for sports-specific activities and activities of daily living. Psychosocial interventions may be warranted after ACLR to reduce injury-related fear and mitigate potentially maladaptive neuroplasticity after ACLR.

Negative Effects on Postural Control After Anterior Cruciate Ligament Reconstruction as Measured by the Balance Error Scoring System

2013 ◽  
Vol 22 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Mason D. Smith ◽  
David R. Bell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Postural Control ◽  
Acl Reconstruction ◽  
Outcome Measures ◽  
Scoring System ◽  
Cruciate Ligament ◽  
Balance Deficits ◽  
Balance Error Scoring System ◽  
Anterior Cruciate ◽  
Balance Error

Context:Anterior cruciate ligament (ACL) reconstruction is the standard of care for individuals with ACL rupture. Balance deficits have been observed in patients with ACL reconstruction (ACLR) using advanced posturography, which is the current gold standard. It is unclear if postural-control deficits exist when assessed by the Balance Error Scoring System (BESS), which is a clinical assessment of balance.Objective:The purpose of this study is to determine if postural-control deficits are present in individuals with ACLR as measured by the BESS.Participants:Thirty participants were included in this study. Fifteen had a history of unilateral ACLR and were compared with 15 matched controls.Interventions:The BESS consists of 3 stances (double-limb, single-limb, and tandem) on 2 surfaces (firm and foam). Participants begin in each stance with hands on their hips and eyes closed while trying to stand as still as possible for 20 s.Main Outcome Measures:Each participant performed 3 trials of each stance (18 total), and errors were assessed during each trial and summed to create a total score.Results:We observed a significant group × stance interaction (P = .004) and a significant main effect for stance (P < .001). Post hoc analysis revealed that the ACLR group had worse balance on the single-leg foam stance than did controls. Finally, the reconstructed group had more errors when total BESS score was examined (P = .02).Conclusions:Balance deficits exist in individuals with ACLR as measured by the BESS. Total BESS score was different between groups. The only condition that differed between groups was the single-leg stance on the unstable foam surface.

There is an Association of Synovial Interleukin-6 Levels With Chondral Damage in Anterior Cruciate Ligament–Deficient Knees

2021 ◽  
pp. 155633162199200
Author(s):  
Ravi Gupta ◽  
Anil Kapoor ◽  
Sourabh Khatri ◽  
Dinesh Sandal ◽  
Gladson David Masih
Keyword(s):  
Anterior Cruciate Ligament ◽  
Synovial Fluid ◽  
Acl Reconstruction ◽  
Inflammatory Cytokines ◽  
Interleukin 6 ◽  
Cruciate Ligament ◽  
Interleukin 1 ◽  
Chondral Damage ◽  
Anterior Cruciate ◽  
Acl Deficient

Background: Osteoarthritis (OA) in the anterior cruciate ligament (ACL)–deficient knee is seen in approximately 50% of affected patients. Possible causes include biochemical or biomechanical changes. Purpose: We sought to study the correlation between inflammatory cytokines and chondral damage in ACL-deficient knees. Methods: Seventy-six male patients who underwent ACL reconstruction were enrolled in a cross-sectional study. Synovial fluid was aspirated before surgery and analyzed for levels of the inflammatory cytokines tumor necrosis factor-α, interleukin-1 (IL-1), and interleukin-6 (IL-6). At the time of ACL reconstruction, the severity of chondral damage was documented as described by the Outerbridge classification. Results: Patients with grade 2 or higher chondral damage were observed to have elevated IL-6 levels when compared to patients who had no chondral damage. Interleukin-6 levels had no correlation with the duration of injury. Conclusion: Elevated levels of IL-6 in synovial fluid were associated with chondral damage in ACL-deficient knees. Further study is warranted to determine whether inflammatory cytokines contribute to the development of OA of the knee after ACL injury.

scholarly journals Nonsurgical Management of an Anterior Cruciate Ligament-Deficient Knee in a Women's Soccer Player: A Validation Clinical Case Report

2017 ◽  
Vol 52 (11) ◽  
pp. 1079-1083
Author(s):  
Courtney E. Gray ◽  
Chris Hummel ◽  
Todd Lazenby
Keyword(s):  
Randomized Controlled Trial ◽  
Anterior Cruciate Ligament ◽  
Case Report ◽  
Soccer Player ◽  
Controlled Trial ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Randomized Controlled ◽  
Anterior Cruciate ◽  
Acl Deficient

Background:  A collegiate women's soccer player sustained an isolated anterior cruciate ligament (ACL) tear and expressed a desire to continue her season without surgical intervention. Design:  Case report. Intervention(s):  Using the results of a randomized controlled trial and published clinical guidelines, the clinicians classified the patient as an ACL-deficient coper. The patient completed her soccer season without incident, consistent with the findings of the established clinical guidelines. However, 6 months later, she sustained a meniscal tear, which was not unexpected given that 22% of ACL-deficient copers in the randomized controlled trial incurred a meniscal tear within 24 months of ACL injury. Conclusion:  The external evidence was helpful in making informed clinical decisions regarding patient care.

scholarly journals Magnetic Tracking: A Novel Method of Assessing Anterior Cruciate Ligament Deficiency

2006 ◽  
Vol 88 (1) ◽  
pp. 16-17 ◽  
Author(s):  
RK Kundra ◽  
JD Moorehead ◽  
N Barton-Hanson ◽  
SC Montgomery
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tracking System ◽  
Cruciate Ligament ◽  
Magnetic Tracking ◽  
Lachman Test ◽  
Acl Deficiency ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tracking Device ◽  
Acl Deficient

INTRODUCTION The Lachman test is commonly performed as part of the routine assessment of patients with suspected anterior cruciate ligament (ACL) deficiency. A major drawback is its reliance on the clinician's subjective judgement of movement. The aim of this study was to quantify Lachman movement using a magnetic tracking device thereby providing a more accurate objective measure of movement. PATIENTS AND METHODS Ten patients aged 21–51 years were assessed as having unilateral ACL deficiency with conventional clinical tests. These patients were then re-assessed using a Polhemus Fastrak™ magnetic tracking device. RESULTS The mean anterior tibial displacement was 5.6 mm (SD = 2.5) for the normal knees and 10.2 mm (SD = 4.2) for the ACL-deficient knees. This gave an 82% increase in anterior tibial displacement for the ACL deficient knees. This was shown to be highly significant with P = 0.005. CONCLUSIONS The magnetic tracking system offers an objective quantification of displacements during the Lachman test. It is convenient, non-invasive and comfortable for the patient and is, therefore, ideally suited for use as an investigative tool.

scholarly journals Anterior Cruciate Ligament Rupture and Osteoarthritis Progression

2012 ◽  
Vol 6 (1) ◽  
pp. 295-300 ◽  
Author(s):  
James Min-Leong Wong ◽  
Tanvir Khan ◽  
Chethan S Jayadev ◽  
Wasim Khan ◽  
David Johnstone
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Degenerative Change ◽  
Acl Rupture ◽  
Osteoarthritis Progression ◽  
Anterior Cruciate ◽  
The Relationship ◽  
Meniscal Damage ◽  
Acl Deficient

Anterior Cruciate Ligament (ACL) rupture is a common sporting injury that frequently affects young, athletic patients. Apart from the functional problems of instability, patients with ACL deficient knees also develop osteoarthritis. Although this is frequently cited as an indication for ACL reconstruction, the relationship between ACL rupture, reconstruction and the instigation and progression of articular cartilage degenerative change is controversial. The purpose of this paper is to review the published literature with regards ACL rupture and the multifactorial causes for osteoarthritis progression, and whether or not this is slowed or stopped by ACL reconstruction. There is no evidence in the published literature to support the view that ACL reconstruction prevents osteoarthritis, although it may prevent further meniscal damage. It must be recognised that this conclusion is based on the current literature which has substantial methodological limitations.

Intra-articular injection of hydrogen sulfide decreased the progression of gonarthrosis

2019 ◽  
Vol 97 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Kürşad Aytekin ◽  
Selma Şengiz Erhan ◽  
Züleyha Erişgin ◽  
Cem Zeki Esenyel ◽  
Selçuk Takır
Keyword(s):  
Anterior Cruciate Ligament ◽  
Hydrogen Sulfide ◽  
Synovial Fluid ◽  
Scoring System ◽  
Cruciate Ligament ◽  
The Other ◽  
Sodium Hydrosulfide ◽  
Medial Meniscectomy ◽  
Anterior Cruciate

Hydrogen sulfide (H2S) is found in both the plasma and synovial fluid of patients with gonarthrosis. In the present study, we investigated whether intra-articular injection of sodium hydrosulfide (NaSH) (1 mM, 30 μL), a H2S donor, might affect gonarthrosis in rats. Gonarthrosis was induced surgically in the left knees of rats and left for 6 weeks for the development of disease. Then, intra-articular injections of NaSH or methylprednisolone (1 mg/kg, 30 μL) were administered to rats. Half of each group was sacrificed at the end of the first day and the other half was sacrificed at the end of 4 weeks to evaluate early and later effects of injections on gonarthrosis. The injury induced by anterior cruciate ligament resection and medial meniscectomy in rats caused the development of gonarthrosis. As the duration lengthened after gonarthrosis induction, the progression of the disease continued. According to the modified Mankin Scoring System, intra-articular injection of NaSH histopathologically slowed the progression of gonarthrosis, whereas methylprednisolone was ineffective. In addition, NaSH decreased apoptosis in rat knees with gonarthrosis. Each treatment did not cause injury to healthy knees. Our results lead to the consideration that intra-articular NaSH administration may be effective in the progression of gonarthrosis.

scholarly journals The impact of anterior cruciate ligament deficiency and reconstruction on bilateral thigh muscle activity during stair descent

2001 ◽  
Vol 57 (2) ◽  
pp. 16-21 ◽  
Author(s):  
A. St Clair Gibson ◽  
M. I. Lambert ◽  
C. L. Vaughan ◽  
M. Lowery ◽  
M. J. O'Malley ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Vastus Lateralis ◽  
Cruciate Ligament ◽  
Thigh Muscle ◽  
Emg Activity ◽  
Vastus Medialis ◽  
Stair Descent ◽  
Step Down ◽  
Anterior Cruciate ◽  
Acl Deficient

Aim: To assess electromyographic (EMG) gait pattern changes during stair descent in subjects with chronic anterior cruciate ligament (ACL) deficiency, and in subjects after ACL reconstruction.Methods: Thirteen ACL deficient subjects (ACLdef), 8 ACL reconstructed subjects (ACLrec), and 10 controls (CON) participated in the study. All subjects were assessed for functional and lean thigh volume (LTV) differences in the injured and uninjured limb. All subjects then stepped off a bench with EMG electrodes on the vastus medialis, vastus lateralis and hamstrings muscles of both limbs.Results: Step down activity caused similar EMG responses in the injured and supporting limb in the ACLdef group compared to that in the control group. In contrast, in the ACLrec group, the onset of EMG activity occurred earlier during the step down activity in the vastus medialis and vastus lateralis of the supporting limb. There was significantly greater EMG activity in the vastus lateralis and hamstring muscles of the supporting limb (p < 0.05) in the ACLrec group compared to ACLdef and control groups. The changes in EMG activity did not appear to be related to differences in LTV, since greater LTV deficits were present in the ACLdef compared to the ACLrec group (p < 0.01).Conclusions: In ACL reconstructed subjects, changes in muscle recruitment patterns in the supporting limb during step down activity have been identified. This altered activity pattern was not present in the supporting limb of ACL deficient subjects

Sign in / Sign up

Export Citation Format

Share Document