scholarly journals 16 Relationships between a multidirectional reactive agility test, functional performance and patient-reported outcome measures 6 months after anterior cruciate ligament reconstruction

2019 ◽  
Author(s):  
Bart Dingenen ◽  
Jan Truijen ◽  
Johan Bellemans ◽  
Alli Gokeler
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Functional Performance ◽  
Cruciate Ligament ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cruciate Ligament Reconstruction ◽  
Patient Reported ◽  
Reactive Agility ◽  
Anterior Cruciate

Patient-reported outcome measures following anterior cruciate ligament reconstruction are not related to dynamic knee extension angle

2018 ◽  
Vol 3 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Kanto Nagai ◽  
Elmar Herbst ◽  
Tom Gale ◽  
Yasutaka Tashiro ◽  
James J Irrgang ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Patient Reported Outcome Measures ◽  
Knee Extension ◽  
Patient Reported Outcome ◽  
Cruciate Ligament Reconstruction ◽  
Knee Hyperextension ◽  
Patient Reported ◽  
Anterior Cruciate

ObjectivesControversy still exists on whether knee hyperextension affects the outcome following anterior cruciate ligament reconstruction (ACL-R). Therefore, the purpose of the present study was to determine if maximum knee extension angle of ACL-R knees and contralateral uninjured knees during walking is related to the clinical outcome following ACL-R. It was hypothesised that maximum knee extension angle would not be significantly correlated with patient-reported outcome measures (PROMs) following ACL-R.MethodsForty-two patients (age at surgery: 23±9 years, 23 male and 19 female) underwent unilateral ACL-R. Twenty-four months after surgery, subjects performed level walking on a treadmill while biplane radiographs were acquired at 100 Hz. Three-dimensional tibiofemoral motion was determined using a validated model-based tracking process. Tibiofemoral rotations were calculated from foot strike through early stance. The primary kinematic outcome measure was maximum knee extension angle of ACL-R and contralateral uninjured knees during walking, with positive values indicating hyperextension. The side-to-side difference (SSD) in maximum knee extension angle was calculated by subtracting the angle of the contralateral uninjured knee from that of the ACL reconstructed knee. PROMs (International Knee Documentation Committee Subjective Knee Form, Knee Injury and Osteoarthritis Score and Marx Activity Rating Scale) were obtained at 24 months after surgery. Correlations between PROMs and maximum dynamic knee extension angle in ACL-R and contralateral knee were evaluated (P<0.05).ResultsMaximum knee extension angle during walking was 2.3±4.5° in ACL-R knees and 4.3±4.2° in contralateral uninjured knees at 24 months after surgery, indicating hyperextension during walking on average. SSD in maximum knee extension angle was −2.0±3.7°. No significant correlation was observed between maximum knee extension angle and the PROMs.ConclusionMaximum knee extension angle during walking was not significantly correlated with PROMs, suggesting that clinically, physiologic knee hyperextension can be restored after ACL-R and not adversely affect PROMs.Level of evidenceLevel III.

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.

Posteromedial versus Anteromedial Hamstring Tendon Harvest for Anterior Cruciate Ligament Reconstruction: A Retrospective Comparison of Accidental Gracilis Harvests, Outcomes, and Operative Times

2018 ◽  
Vol 32 (11) ◽  
pp. 1121-1127 ◽  
Author(s):  
Henry T. Shu ◽  
Blake M. Bodendorfer ◽  
Evan M. Michaelson ◽  
Evan H. Argintar
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
Hamstring Tendon ◽  
Patient Reported Outcome Measures ◽  
Cruciate Ligament Reconstruction ◽  
Patient Reported ◽  
Anterior Cruciate

AbstractHamstring autografts are frequently harvested for anterior cruciate ligament reconstruction (ACLR), traditionally through the anteromedial (AM) approach. Recently, a posteromedial (PM) approach has been described. The primary purpose of this study was to compare rates of unintentional gracilis (Gr) harvest or premature tendon amputation with these approaches. We also sought to compare operative times and patient-reported outcome measures (PROMs) between both groups and between those with only semitendinosus (ST) grafts or with combined ST and Gr grafts. Patients who underwent ACLR with hamstring autograft by a single surgeon from 2014 to 2016 were retrospectively reviewed. An accidental harvest was identified as an unintentional Gr harvest or premature graft amputation. PROMs included the Knee Osteoarthritis and Outcomes Score, Western Ontario and McMaster Universities Osteoarthritis Index, and International Knee Documentation Committee score. Two out of 22 (9.1%) patients in the AM group had unintentional Gr tendon harvests, while none (out of 29) were identified in the PM group (p = 0.101). Group mean PROMs were not significantly different between patients in either group or patients with either ST-only grafts and those with combined ST + Gr. Average operative times and tourniquet times were significantly shorter with the PM approach versus the AM approach (101 ± 18.2 vs 129 ± 25.6 minutes, p = 0.002; 68 ± 14.8 vs 90 ± 28.9 minutes, p = 0.005). The PM approach was associated with a trend toward decreased risk of unintentional harvest of the Gr tendon and significantly decreased operative and tourniquet times without affecting knee outcomes compared with the traditional AM approach. Accidental Gr harvest was not associated with worse outcomes.

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