scholarly journals Study of proprioception and muscle strength following arthroscopic anterior cruciate ligament reconstruction

2021 ◽  
Vol 7 (3) ◽  
pp. 502
Author(s):  
Shankarlinga S. ◽  
Basavaraj S. Kyavater ◽  
Manik Rana
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Graft ◽  
Cruciate Ligament Reconstruction ◽  
Knee Mechanics ◽  
Anterior Cruciate

<p><strong>Background:</strong> Mechanoreceptors plays a vital role in knee mechanics. Since there are controversies surrounding the overall recovery time of proprioception following surgery, it is necessary to define the factors affecting proprioceptive recovery after anterior cruciate ligament reconstruction and to investigate the relationship between proprioception and muscle strength following surgery.</p><p><strong>Methods: </strong>Current study is combined prospective and retrospective study done at K. S. hospital Koppal, spanning for a period of one year (December 2019 to December 2020). All patients presented with isolated anterior cruciate ligament (ACL) tear were included in the study. Patients were treated by arthroscopic ACL reconstruction with hamstring graft only and followed up for a period of year. Outcome measures include centre of mass proprioception in AP and medio-lateral direction and muscular strength through force gauze in Newton.</p><p><strong>Results:</strong> 26 patients (mean age 33) were included in the study, all ACL tears were treated by arthroscopic ACL reconstruction with hamstring graft and they underwent varying period of rehabilitation.</p><p><strong>Conclusions:</strong> This study shows that our understanding of biomechanics of ACL reconstructed knees is still evolving, and proprioception is found to be a key factor in determining post-op recovery. ACL remnant preservation intra-op along with proper mechanical positioning of the graft may help in better proprioception and functional outcome following the reconstruction.</p>

Perioperative Opioid Use in Anterior Cruciate Ligament Reconstruction Patients

2021 ◽  
Author(s):  
Ali Aneizi ◽  
Elizabeth Friedmann ◽  
Leah E. Henry ◽  
Gregory Perraut ◽  
Patrick M. J. Sajak ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

AbstractAnterior cruciate ligament reconstruction (ACLR) is one of the most commonly performed outpatient orthopaedic procedures, yet there is little data about perioperative opioid prescribing practices. The purposes of this study were to quantify the perioperative opioid prescriptions filled by patients who underwent ACLR and to identify factors associated with greater postoperative opioid use. Patients who underwent ACLR at a single institution between June 2015 and May 2017 were studied using a regional prescription monitoring database to identify all preoperative and postoperative outpatient opioid prescriptions up to 2 years postoperatively. The number of morphine milligram equivalents of each opioid was calculated to determine total morphine milligram equivalents (TMEs) filled preoperatively, at discharge, and refilled postoperatively. Patients who refilled an opioid prescription postoperatively were compared with those who did not. Ninety-nine of 269 (36.8%) total patients refilled an opioid prescription postoperatively. Thirty-three patients (12.3%) required a refill after 2 weeks postoperatively, and no patients refilled after 21 months postoperatively. Fifty-seven patients (21%) received an opioid prescription in the 2 years following surgery that was unrelated to their ACL reconstruction. Increased age, higher body mass index (BMI), government insurance, current or prior tobacco use history, preoperative opioid use, and greater number of medical comorbidities were significantly associated with refilling a prescription opioid. Higher BMI and government insurance were independent predictors of refilling. Higher preoperative TMEs and surgeon were independent predictor of greater refill TMEs. In the opioid-naïve subgroup of 177 patients, only higher BMI was a predictor of refilling, and only greater comorbidities was a predictor of greater refill TMEs. The results demonstrate that preoperative opioid use was associated with postoperative opioid refills and higher refill TMEs in a dose-dependent fashion. A higher percentage of patients received an opioid prescription for reasons unrelated to the ACL reconstruction than refilled a prescription after the first 2 weeks postoperatively.

scholarly journals Variation in Gastrocnemius and Hamstrings Muscle Activity During Peak Knee Flexor Force After Anterior Cruciate Ligament Reconstruction With Hamstring Graft: Preliminary Controlled Study

2020 ◽  
Author(s):  
Luna SEQUIER ◽  
Florian Forelli ◽  
Maude TRAULLÉ ◽  
Amaury VANDEBROUCK ◽  
Pascal Duffiet ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Muscular Activity ◽  
Medial Gastrocnemius ◽  
Hamstring Graft ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Experimental Group

Background: The optimisation of this return to athletic activity pass by a better understanding of the behaviour of the muscle involved in knee function.In this study, we focused on the muscular activity of the muscle involved in the flexion of the knee. Preciseley on the relation between the muscular activity of the gastrocnemius and the hamstring among the patient that underwent an anterior cruciate ligament reconstruction with hamstring graft.Objective : The objective of the study is to compare, the muscular activity of the flexor knee muscle in patient that underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals that have not undergone surgery.Methods : The participants have been divided into two groups : an healthy group and an experimental group that underwent an anterior cruciate ligament recontruction with hamstring graft. The participants had to performe a strenght test on a isocinetik dynamometer. The activity of the medial gastrocnemius, lateral gastrocnemius, femoral biceps and the semitendinosus were mesured during this test.The muscular activity of the muscle mentioned of the individuals in the first group were compared to the ones in the second group via a statistical analysis. Then, a ratio of the activity of the gastrocnemius muscle on the activity of the hamstring was calculated The results of the experimental group were then compared to the results of the control groupResults : The results showed a significative difference activity of the medial gastrocnemius, the femoral biceps and the semitendinosus muscles : the experimental group results were superior to the control group results However the evaluation of the activity reporting has shown significant differences in the two groupsConclusion : This study has allowed us to show a difference in muscular activity of the gastrocnemius and hamstring muscle between patient that underwent an anterior cruciate ligament reconstruction surgery and the heathy participants. However our approch has not allowed us to identify the relation between a heihtened gastrocnemius activity and a diminished hamstring activity following an anterior cruciate ligament reconstruction with hamstring graft. Quite on the contrary, we observed a higher activity of the two muscle groups. Nevertheless, it seem to be necessary to have a variation in situations during the analysis of the gastrocnemius muscle to fully understans its purpose in the functional activity of the knee of patient that have undergone an anterior cruciate ligament reconstruction.

scholarly journals The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction

2018 ◽  
Vol 7 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Y. Sato ◽  
R. Akagi ◽  
Y. Akatsu ◽  
Y. Matsuura ◽  
S. Takahashi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Bone Healing ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Bone Tunnel ◽  
Femoral Bone ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Objectives To compare the effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament (ACL) reconstruction animal model. Methods Anterior cruciate ligament reconstruction using the plantaris tendon as graft material was performed on both knees of 24 rabbits (48 knees) to mimic ACL reconstruction by two different suspensory fixation devices for graft fixation. For the adjustable fixation device model (Socket group; group S), a 5 mm deep socket was created in the lateral femoral condyle (LFC) of the right knee. For the fixed-loop model (Tunnel group; group T), a femoral tunnel penetrating the LFC was created in the left knee. Animals were sacrificed at four and eight weeks after surgery for histological evaluation and biomechanical testing. Results Histologically, both groups showed a mixture of direct and indirect healing patterns at four weeks, whereas only indirect healing patterns were observed in both groups at eight weeks. No significant histological differences were seen between the two groups at four and eight weeks in the roof zone (four weeks, S: mean 4.8 sd 1.7, T: mean 4.5 sd 0.5, p = 0.14; eight weeks, S: mean 5.8 sd 0.8, T: mean 4.8 sd 1.8, p = 0.88, Mann-Whitney U test) or side zone (four weeks, S: mean 5.0 sd 1.2, T: mean 4.8 sd 0.4, p = 0.43; eight weeks, S: mean 5.3 sd 0.8,T: mean 5.5 sd 0.8, p = 0.61, Mann-Whitney U test) . Similarly, no significant difference was seen in the maximum failure load between group S and group T at four (15.6 sd 9.0N and 13.1 sd 5.6N) or eight weeks (12.6 sd 3.6N and 17.1 sd 6.4N, respectively). Conclusion Regardless of bone tunnel configuration, tendon-bone healing after ACL reconstruction primarily occurred through indirect healing. No significant histological or mechanical differences were observed between adjustable and fixed-loop femoral cortical suspension methods. Cite this article: Y. Sato, R. Akagi, Y. Akatsu, Y. Matsuura, S. Takahashi, S. Yamaguchi, T. Enomoto, R. Nakagawa, H. Hoshi, T. Sasaki, S. Kimura, Y. Ogawa, A. Sadamasu, S. Ohtori, T. Sasho. The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study. Bone Joint Res 2018;7:327–335. DOI: 10.1302/2046-3758.75.BJR-2017-0238.R2.

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