scholarly journals Impact of Physiotherapy rehabilitation program on postoperative ACL tear patient on prognosis leading to maintain consistency in sport

2020 ◽  
Vol 11 (3) ◽  
pp. 4821-4825
Author(s):  
Prasad Risaldar ◽  
Akshata Raut ◽  
Dushyant Bawiskar ◽  
Waqar M. Naqvi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Rehabilitation Program ◽  
Clinical Findings ◽  
Acl Tear ◽  
Anterior Cruciate ◽  
Typical Treatment ◽  
Joint Integrity ◽  
Loss Of Strength

Anterior cruciate ligament (ACL) injury is a devastating injury that occurs at high frequency during involvement in competitive sporting activity. Typical treatment of ACL damage is a reconstruction of the anterior cruciate ligament (ACLR). It is projected that between 50 percent and 60 percent of ACL injured athletes will return to competitive sport. Athletes undergoing ACLR surgery are recommended for comprehensive rehab and preparedness to rebuild knee joint integrity and specific functional criteria to direct the comeback to sport to protect against secondary ACL damage.Patient main concerns were pain, with loss of strength and stability at the knee joint, the clinical findings found that there was a marked decrease in range of motion (ROM), and decreased strength of the quadriceps and the hamstrings.Diagnosis of case was grade 2 ACL tear which was confirmed by the MRI reports.The patient showed a great co-operation during the intervention period and now the subject is able to maintain his consistency in his sport. The outcome measures of physical therapy intervention progressed him in an enhanced athlete with return to his sport.

scholarly journals Early Quadriceps Wasting after Anterior Cruciate Ligament Reconstruction in Young Adults: A Prospective Study

2021 ◽  
Author(s):  
Shubham Agarwal ◽  
Hemant Jain ◽  
Kishore Raichandani ◽  
Jagdish Godara ◽  
Sunil Choudhary
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
Thigh Circumference ◽  
Femur Length ◽  
Acl Tear ◽  
Measuring Tape ◽  
Anterior Cruciate ◽  
Prospective Longitudinal

Introduction: Anterior Cruciate Ligament (ACL) is the most commonly injured ligament in the knee that requires surgical intervention. The weakness of quadriceps muscle is a sequele of ACL tear that can persist even after reconstruction. Muscle wasting if identified in early postoperative period can help to formulate structured protocols for rehabilitation that can help patient to recover. Best available method for scan of the same includes Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scan, but it is neither accessible nor affordable to masses of population. Aim: To evaluate the quadriceps thickness using an easily available modality i.e., Ultrasonography (USG) and thigh circumference to detect early wasting. Materials and Methods: This prospective longitudinal study was done on 48 patients between the ages of 18-45 years with ACL tear operated arthroscopically. After six months of surgery, all patients were evaluated for quadriceps thickness using USG and thigh circumference using traditional measuring tape at the same points. Paired t-test was used for evaluation of the results. Results: This study quantifies quadriceps thickness using USG at two distinct levels of the thigh and found a significant deficit of 13.05% in the involved extremity at 1/3rd of femur length from knee joint and a deficit of 11.72% in involved extremity at 2/3rd of femur length from knee joint. This study established that the quadriceps of the involved extremity definitely goes under atrophy despite early rehabilitation. Also, there was a deficit of 5.04% in thigh circumference at 1/3rd of femur length from knee joint and 4.43% at 2/3rd of femur length from knee joint in the operated limb. There was no positive correlation between both the methods. Conclusion: This study concluded that USG is an easily available and affordable method to determine quadriceps thickness and it’s wasting early in the postoperative rehabilitation phase. It can assist in establishing early vigorous rehabilitation protocols. The traditional method of measuring thigh circumference using measuring tape to quantify quadriceps muscle bulk can be misleading as its underestimates the atrophy due to various factors.

scholarly journals Femur-tibia Angle and Patella-tibia Angle: New Indicators for Diagnosing Anterior Cruciate Ligament Tears in Magnetic Resonance Imaging

2021 ◽  
Author(s):  
Zeng Li ◽  
Mengyuan Li ◽  
Yan Du ◽  
Hai Jiang ◽  
Yuanchen Ma ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Youden Index ◽  
Control Group ◽  
Acl Tear ◽  
Anterior Cruciate ◽  
Arthroscopic Knee

Abstract Background: Torn anterior cruciate ligament (ACL) contributes to internal rotation of tibia. However, there is no indicator in MRI to reflect the rotation of knee joint. So the purpose of this study is to introduce two new measurements in MRI, femur-tibia angle (FTA) and patella-tibia angle (PTA), which reflect the rotation of knee joint and assess their role in diagnosing ACL tears.Methods: Present study retrospectively reviewed the cases of primary arthroscopic knee surgery from January 2018 to December 2019 from the Arthroscopy Database at Guangdong Provincial People's Hospital. Firstly, comparisons of different measurements were conducted between the ACL tears group and isolated meniscus injury group. Then, the measurements were tested in diagnosing complete or partial ACL tears. Diagnostic performance of different measurements was assessed by area under the curve (AUC) of receiver operating characteristic (ROC) curve and cutoff values were determined by Youden index. Results: FTA and PTA in ACL tears group had 4.79 and 7.36 degrees more than that of control group (p = 0.022 and < 0.001, respectively). Besides, ACL angle and distance of anterior tibial subluxation (D) also showed significant differences (p<0.05). In distinguishing complete ACL tear with intact ACL, the ROC curves indicated that ACL angle had the highest AUC of 0.906 (95% CI: 0.833-0.978) while AUC of PTA was 0.849 (95% CI: 0.763-0.936) and AUC of FTA was 0.809 (95% CI: 0.710-0.908). In distinguishing partial ACL tear with intact ACL, the ROC curves showed that FTA and PTA had the highest AUCs of 0.847 and 0.813 with 95% CI of 0.737-0.957 and 0.680-0.947, respectively. In contrast, the AUCs of ACL angle and D were only 0.519 and 0.387 with 95% CI of 0.292-0.745 and 0.227-0.546.Conclusion: Present study introduced two new quantitative parameters, FTA and PTA, to assess the rotation of knee joint. FTA and PTA increased when ACL tears and they might be valuable in diagnosing ACL tears, especially in distinguishing partial ACL tear with intact ACL which was poorly diagnosed in MRI.

Orthopedic Anterior Cruciate Ligament Evaluator (OR.A.C.L.E): A Preliminary Design

2015 ◽  
Author(s):  
Davide Piovesan ◽  
David Church ◽  
Sean Herron ◽  
Calvin Oldham ◽  
Mollie Sebald ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Physical Examination ◽  
Physical Therapist ◽  
Cruciate Ligament ◽  
Rapid Prototype ◽  
Cost Effective ◽  
Acl Tear ◽  
Anterior Cruciate ◽  
Injured Knee

An anterior cruciate ligament (ACL) tear is one of the most prominent, and debilitating injuries currently to athletes. Physical therapist students need to be able to practice common physical examination techniques regularly and repeatedly in order to gain the skills necessary to accurately diagnose an ACL tear. A cost effective, adjustable knee apparatus that could mimic the behavior of both a healthy and an injured knee joint may mitigate this problem. We built an apparatus mimicking the geometry and function of a knee joint, including the effect of forces and stiffness proper of knee ligaments. SimWise 4D was used to dynamically simulate an anatomically approximated model of the knee joint during physical examination conditions. The numerical simulation tested the displacement between the femur and the tibia with and without an ACL ligament. The SimWise 4D simulation gave an increase in displacement of 1.58 mm or 30% after removing the ACL, which is comparable with known displacements in human test subjects. Finally, a design for a 3D rapid prototype is proposed and fabricated with fusion deposition modeling (FDM).

The Analysis of Proprioception Alteration during First Five Months after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 1 (84) ◽  
Author(s):  
Vilma Jurevičienė ◽  
Albertas Skurvydas ◽  
Juozas Belickas ◽  
Giedra Bušmanienė ◽  
Dovilė Kielė ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Angular Velocity ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Starting Position ◽  
Angular Velocities ◽  
Anterior Cruciate

Research  background  and  hypothesis.  Proprioception  is  important  in  the  prevention  of  injuries  as  reduced proprioception  is  one  of  the  factors  contributing  to  injury  in  the  knee  joint,  particularly  the  ACL.  Therefore, proprioception appears not only important for the prevention of ACL injuries, but also for regaining full function after ACL reconstruction.Research aim. The aim of this study was to understand how proprioception is recovered four and five months after anterior cruciate ligament (ACL) reconstruction.Research methods. The study included 15 male subjects (age – 33.7 ± 2.49 years) who had undergone unilateral ACL reconstruction with a semitendinosus/gracilis (STG) graft in Kaunas Clinical Hospital. For proprioceptive assessment, joint position sense (JPS) was measured on both legs using an isokinetic dynamometer (Biodex), at knee flexion of 60° and 70°, and at different knee angular velocities of 2°/s and 10°/s. The patients were assessed preoperatively and after 4 and 5 months, postoperatively.Research results. Our study has shown that the JPS’s (joint position sense) error scores  to a controlled active movement is significantly higher in injured ACL-deficient knee than in the contralateral knee (normal knee) before surgery and after four and five months of rehabilitation.  After 4 and 5 months of rehabilitation we found significantly lower values in injured knees compared to the preoperative data. Our study has shown that in injured knee active angle reproduction errors after 4 and 5 months of rehabilitation were higher compared with the ones of the uninjured knee. Proprioceptive ability on the both legs was  independent of all differences angles for target and starting position for movement. The knee joint position sense on both legs depends upon the rate of two different angular velocities and the mean active angle reproduction errors at the test of angular velocity slow speed was the highest compared with the fast angular velocity. Discussion and conclusions. In conclusion, our study shows that there was improvement in mean JPS 4 and 5 months after ACL reconstruction, but it did not return to normal indices.Keywords: knee joint, joint position sense, angular velocity, starting position for movement.

Deconstructing the Anterior Cruciate Ligament: What We Know and Do Not Know About Function, Material Properties, and Injury Mechanics

2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Scott G. McLean ◽  
Kaitlyn F. Mallett ◽  
Ellen M. Arruda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Mechanical Response ◽  
Cruciate Ligament ◽  
Complex Structure ◽  
Acute Injury ◽  
Research Attention ◽  
Increased Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury is a common and potentially catastrophic knee joint injury, afflicting a large number of males and particularly females annually. Apart from the obvious acute injury events, it also presents with significant long-term morbidities, in which osteoarthritis (OA) is a frequent and debilitative outcome. With these facts in mind, a vast amount of research has been undertaken over the past five decades geared toward characterizing the structural and mechanical behaviors of the native ACL tissue under various external load applications. While these efforts have afforded important insights, both in terms of understanding treating and rehabilitating ACL injuries; injury rates, their well-established sex-based disparity, and long-term sequelae have endured. In reviewing the expanse of literature conducted to date in this area, this paper identifies important knowledge gaps that contribute directly to this long-standing clinical dilemma. In particular, the following limitations remain. First, minimal data exist that accurately describe native ACL mechanics under the extreme loading rates synonymous with actual injury. Second, current ACL mechanical data are typically derived from isolated and oversimplified strain estimates that fail to adequately capture the true 3D mechanical response of this anatomically complex structure. Third, graft tissues commonly chosen to reconstruct the ruptured ACL are mechanically suboptimal, being overdesigned for stiffness compared to the native tissue. The net result is an increased risk of rerupture and a modified and potentially hazardous habitual joint contact profile. These major limitations appear to warrant explicit research attention moving forward in order to successfully maintain/restore optimal knee joint function and long-term life quality in a large number of otherwise healthy individuals.

scholarly journals Effective Graft Preservation by Following a Standard Protocol for the Treatment of Knee Joint Infection after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 32 (11) ◽  
pp. 1111-1120
Author(s):  
Robin Otchwemah ◽  
Jan-Hendrik Naendrup ◽  
Frauke Mattner ◽  
Thorsten Tjardes ◽  
Holger Bäthis ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Joint Infection ◽  
Standard Protocol ◽  
Standardized Protocol ◽  
Graft Preservation ◽  
Knee Joint Infection ◽  
Anterior Cruciate

AbstractKnee joint infections constitute a rare but devastating complication after anterior cruciate ligament (ACL) reconstruction. We hypothesized that effective infection therapy and graft preservation is possible following a standard treatment protocol. We retrospectively analyzed all patients admitted to our center with suspected infection of the knee after ACL reconstruction between 2010 and 2012. Following a standardized protocol, blood samples were drawn and synovial fluid was analyzed. Furthermore, the protocol consisted of arthroscopic lavages and debridements of the anterior and posterior joint compartments over three incisions, and targeted antibiotic therapy over a period of 6 weeks. Surgeries were repeated every 2 days until clinical signs of infections resolved, but at least two times. Mean observation period was 10 months. Forty-one patients aged 31 ( ±  9.9) years and admitted 14 ( ±  7.5) days after ACL reconstruction were included. Pathogens were found in 34 patients and coagulase-negative staphylococci were isolated most commonly (31 isolates in 28 patients). Quinolones were the most commonly used antibiotic agents. Mean number of operations was 3.8 ( ± 1.4). Following the standard protocol, primary successful infection treatment with graft preservation was possible in 37 of the included 41 patients. Graft preservation was achieved in 100% of the included patients with Gaechter stage 1 and 2 infections. Knee joint infection after ACL reconstruction was successfully treated following a standardized protocol, and graft preservation was reliably achieved especially in cases with infections at an early stage.

scholarly journals Comprehensive Rehabilitation After Reconstruction of the Anterior Cruciate Ligament

2021 ◽  
Vol 11 (8) ◽  
pp. 182-193
Author(s):  
Dawid Besztak ◽  
Karina Szczypiór-Piasecka ◽  
Alicja Mińko ◽  
Krzysztof Antczak
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
Rehabilitation Process ◽  
History Of ◽  
Comprehensive Rehabilitation ◽  
Anterior Cruciate ◽  
Two Stages ◽  
Hospital Rehabilitation

Introduction: The knee joint is the second most frequently injured joint. Anterior cruciate ligament (ACL) injury is a relatively common injury to the inner part of the knee joint, mainly related to contact sports. Its rupture leads to instability of the entire joint. Two treatment options are possible: operative or conservative. Each of them is related to an appropriate rehabilitation process. The aim of this study was to define a comprehensive rehabilitation plan in patients after ACL rupture and meniscal suturing.Materials and methods: The work was written based on the medical history of the patient who was diagnosed with complete rupture of ACL, and then reconstruction was performed with the harvesting of a semitendinous and slender muscle graft.Results: The rehabilitation process can be divided into two stages: hospital and post-hospital. Rehabilitation in hospital conditions begins on the zero day after arthroscopy. The main goals of rehabilitation include: increasing the range of mobility, no myofascial dysfunctions, no thromboembolic complications, and the ability to self-service.Conclusion: Rehabilitation is an indispensable element of the treatment of patients after ACL reconstruction. Early initiation of rehabilitation brings tangible benefits during treatment and return to full physical fitness.

Sign in / Sign up

Export Citation Format

Share Document