scholarly journals A complex approach in rehabilitation of the patients after the anterior cruciate ligament reconstruction

2019 ◽  
Vol 5 (3) ◽  
pp. 37
Author(s):  
I.Ya Hrubar ◽  
Yu.O. Hrubar ◽  
N.M. Grabyk
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Postoperative Period ◽  
Ligament Reconstruction ◽  
Clinical Course ◽  
Cruciate Ligament ◽  
Control Group ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Experimental Group

<p><strong>The Purpose</strong> was to improve the treatment outcomes of patients who undergo ACL reconstruction under arthroscopic control through a comprehensive approach to their rehabilitation program.<strong> </strong></p><p><strong>Materials and methods. </strong>We have implemented a system of comprehensive rehabilitation of patients after the ACL reconstruction under arthroscopic control, which relied on the phase of the clinical course of the postoperative period.</p><p><strong>Results. </strong>The study involved 40 patients who underwent anterior cruciate ligament reconstruction under arthroscopic control. Experimental group (20 people) who applied a comprehensive approach in rehabilitation after ACL reconstruction, taking into account the phase of the clinical course of the postoperative period. The second group was the control group (20 patients) in which rehabilitation was carried out under the existing program. The use of cryotherapy with adjustable pulse compression in patients of the experimental group from the first day allowed to reduce twice the use of non-narcotic analgesics. Analyzing the dynamics of flexion in the knee joint, it was found that patients of the experimental group on the 25th day performed flexion by 88.46% of the appropriate maximum. Whereas in the control group just - 69.23%. Positive dynamics were noted in the indicators of myotonometry of the quadriceps muscle and measurement of the perimeter of the knee joint.</p><strong>Conclusions.</strong> The program of physical rehabilitation of patients after the anterior cruciate ligament reconstruction under arthroscopic control, which was built taking into account the phase of the clinical course of the postoperative period, has been developed and offered positive results in clinical practice. The effectiveness of the program was shown by the improvement of such indicators as: decrease in intensity of pain syndrome in the early postoperative period, increase in the range of motion in the knee joint, faster restoration of the tone of the quadriceps muscle of the thighs of patients of the experimental group as opposed to the control group

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 Our Point of View at Rehabilitation After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 106 (3) ◽  
pp. 9-17
Author(s):  
I.M. Zazirnyi ◽  
O.O. Kostrub ◽  
V.V. Kotiuk ◽  
O.V. Plugatar
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Postoperative Period ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Rehabilitation Program ◽  
Early Postoperative Period ◽  
Sports Activity ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Summary. The article presents rehabilitation program for the patients after anterior cruciate ligament reconstruction. The program is used at the Feofaniya Hospital’s Center of Orthopedics, Traumatology and Sports Medicine and at the Department of Sports and Ballet Injuries of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. The rehabilitation course is divided on five periods: 1) preoperative period; 2) early postoperative period (acute) (0–2 weeks); 3) function restoring period (up to 9 week); 4) period of preparing and gradual returning to recreation and sports activity (from 9 week); 5) period of returning to full sports activity (after 6–9 months, depending on the type of sport). Principles of postoperative care and rehabilitation in our clinics are as follows: 1) decreasing pain, swelling, and inflammation; 2) full load of the operated on limb with or without crutches; 3) immediate exercises to restore range of motion from 0° to 60–90°, with gradually increase to 120° and full flexion after 6–9 weeks postoperatively (using continuous passive motion; passive, active assisted, and active exercises); 4) exercises for training quadriceps muscle, shin flexor muscles and all lower limb and pelvis muscles, with increasing resistance in close and open kinetic chains; 5) exercises for training proprioception and coordination (from early postoperative period); 6) return to work after 3–6 weeks, health-improvement and sports activity after 4, 6, and 9 months; 7) close cooperation between a surgeon, a rehabilitologist, and a patient during rehabilitation. We focus on achieving the fastest full extension of the knee joint, muscle control and restoration of proprioception. Exercises are performed in closed and open kinetic chains, with muscles tension in the back of the thigh and shin, in the way to avoid too much stress on transplantate. In cases of athletes and recreational active patients, elements of sports specific exercises were included to the rehabilitation program (from early postoperative period). That helped to restore proper patterns of movements and to overcome physical barrier in returning to full sports activity. Return to sport was allowed patients when achieved full range of motion, normal proprioception and balance of muscles; functional tests results were about 90% of the norm and there was no pain or swelling during exercise loads.

scholarly journals Effect of Eight Weeks of Core Stability Exercises on Dynamic Balance, Function, and Strength in Athletes after Anterior Cruciate Ligament Reconstruction: Randomized Clinical Trial

2021 ◽  
Author(s):  
Farzaneh Saki ◽  
Mehrdad Anbariyan ◽  
Hossein Shafiei ◽  
Shima Bakhtiari
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Dynamic Balance ◽  
Cruciate Ligament ◽  
Core Stability ◽  
Balance Function ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Experimental Group

Introduction: The core muscles of trunk are activated before movements of upper and lower limbs. Current evidence suggests that lose of stability in core region predisposes to second injury and appropriate exercise may reduce the risk of reinjury. This aim of this study was to evaluate the effect of eight weeks core stability exercises on dynamic balance, function and strength in athletes after anterior cruciate ligament reconstruction. Methods: This study was a randomized clinical trial. 26 athletes with a history of anterior cruciate ligament reconstruction were purposefully selected and randomly divided into experimental and control groups. The experimental group performed core stability exercises for eight weeks and the control group performed their daily exercises. Dynamic balance, isometric strength and function were meaured using Y balance test, hand held dynamometer and hop tests. Data were analyzed using SPSS vrsion16 software. Independent t-test was used to compare demographic characteristics and Mixed Repeated Measures ANOVA was used to compare the means of the two groups (p≤.05). Results: The results of the present study showed significant improvement in dynamic balance (F=143.92, P=0.000), single-leg hop (F=68.25, P=0.000), triple hop (F=14.02, P= 0.001), knee flexor strength (F=50.21, P=0.000) and knee extensor strength (F=54.72, P=0.000) in the experimental group after eight weeks of core stability exercises. Conclusion: Based on the results of present study, it is suggested to the specialists and trainers involed in the rehabilitation of athletes to use comprehensive and useful core stabilization exercises in the rehabilitation stages of knee injuries.

scholarly journals Effectiveness of platelet-rich plasma in the treatment of anterior cruciate ligament injuries: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Wenfan Gan ◽  
Zheng Xu ◽  
Chunmei Wu ◽  
Junzhi He
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Platelet Rich Plasma ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Control Group ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Abstract Background: Recently, a number of randomized controlled trials (RCTs) have researched the efficacy of anterior cruciate ligament reconstruction (ACLR) combined with platelet-rich plasma (PRP) in the treatment of anterior cruciate ligament (ACL) injuries. Therefore, we updated a systematic review based on these RCTs to evaluate the effects of PRP on knee function and pain with different time.Methods: We searched in PubMed, Embase, Cochrane, Web of Science(WOS), China National Knowledge Infrastructure(CNKI), and WANFANG DATABASE, for human RCTs comparing the efficacy of intraarticular injection with no injection of PRP. Descriptive summaries and quality assessments were performed for all studies included in this meta-analysis. The outcomes of the stydy included the International Knee Documentation Committee (IKDC), Visual Analogue Scale (VAS), and Lysholm score.Results: Finally, we included 6 RCTs stydies, involving 315 patients. The control group consisted of blank group or placebo group. Follow-up periods ranged from 3 to 18 months. The results of bias risk assessment showed that all the 6 stuydies are unclear risk of bias. Compared with the control group, PRP group significantly improved IKDC score at 3, 6 and 12 months after operation (P = 0.00, 0.01, respectively). Lysholm score and VAS score also has significant differences at 3 months after operation (both P = 0.00).Conclusion: Our study has proved that PRP was more effective in the recovery of knee function and early pain relief after the ACLR than the ACLR alone. Review registration: PROSPERO CRD42021224182. Registered 6 April 2021. Keywords:anterior cruciate ligament injury; anterior cruciate ligament reconstruction; platelet rich plasma; system review; META analysisReview registration: PROSPERO CRD42021224182. Registered 6 April 2021.

Anterior Cruciate Ligament Reconstruction with and without a Ligament Augmentation Device

2002 ◽  
Vol 30 (6) ◽  
pp. 851-856 ◽  
Author(s):  
Jon Olav Drogset ◽  
Torbjørn Grøntvedt
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Control Group ◽  
Long Term Effects ◽  
Cruciate Ligament Reconstruction ◽  
Ligament Augmentation ◽  
Significant Difference ◽  
Anterior Cruciate

Background Ligament augmentation devices have been used in anterior cruciate ligament reconstruction since the suggestion of Kennedy et al. in 1980 that such devices would allow grafts to heal faster and more safely. Hypothesis Patients who had augmentation will have better outcomes after 8 years. Study Design Prospective randomized case control study. Methods Between 1991 and 1993, 100 patients were randomized to groups undergoing anterior cruciate ligament reconstruction with bone-patellar tendon-bone grafts with (49) or without (51) use of a Kennedy ligament augmentation device. Of these 100 patients, 94 were examined at an average of 8 years after surgery. Fifteen patients were excluded because of rupture in the other knee and 11 because of rerupture in the same knee. Results Of the remaining 68 patients, the mean Lysholm function score was 84 in the augmentation group and 87 in the control group. There was a statistically significant relationship between preoperatively detected cartilage injury and osteoarthritis. Almost half of the patients had developed osteoarthritis. We observed no significant difference between the two groups concerning rerupture rate, Lysholm or Lachman test scores, or KT-1000 arthrometer measurements. Conclusions We found no positive long-term effects supporting the use of augmentation in anterior cruciate ligament reconstruction.

scholarly journals Improving Maximal Strength in the Initial Postoperative Phase After Anterior Cruciate Ligament Reconstruction Surgery: Randomized Controlled Trial of an App-Based Serious Gaming Approach (Preprint)

2019 ◽  
Author(s):  
Jan-Dierk Clausen ◽  
Niclas Nahen ◽  
Hauke Horstmann ◽  
Florian Lasch ◽  
Werner Krutsch ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Intervention Group ◽  
Maximum Strength ◽  
Control Group ◽  
Serious Gaming ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

BACKGROUND Anterior cruciate ligament reconstruction surgery is one of the most common orthopedic procedures. One of the main factors that influence the outcome is regaining strength in the postoperative phase. Because anterior cruciate ligament reconstruction surgeries are often performed in young patients, we combined the concept of prehabilitation with an app-based serious gaming approach to improve maximal strength postoperatively. OBJECTIVE Our objective was to conduct a prospective randomized trial to evaluate whether an app-based active muscle training program (GenuSport Knee Trainer) can improve postoperative strength by starting rehabilitation immediately after primary anterior cruciate ligament reconstruction surgery. METHODS We designed a pilot study in which we randomly assigned patients receiving primary anterior cruciate ligament reconstruction to either the serious gaming training (intervention) group or a conventional rehabilitation (control) group. Except for the serious gaming-based training, both groups followed the same postoperative treatment protocol. Outcome parameters were absolute and relative change in maximal strength, as well as the International Knee Documentation Committee Subjective Knee evaluation form, Knee Injury and Osteoarthritis Outcome Score, and Lysholm Knee Score. RESULTS In total 26 patients agreed to participate (14 patients in the intervention group and 12 patients in the control group, 1 of whom was lost to follow-up). We noted a difference in absolute maximum strength between the exergaming intervention and the control groups. Mean maximum strength preoperatively was 155.1 (SD 79.2) N in the intervention group (n=14) and 157.0 (SD 40.8) N in the control group (n=11). Postoperative mean maximum strength was 212.8 (SD 78.5) N in the intervention group and 154.5 (SD 27.1) N in the control group. Mean absolute change in maximum strength was 57.7 (SD 95.2) N in the intervention group and –4.8 (22.2) N in the control group. The analysis of covariance model with absolute change as the dependent variable and treatment group and baseline maximum strength as covariates showed a relevant difference in relative change between treatment groups (intervention – control) of 59.7 N (95% CI 10.1-109.3; <i>P</i>=.02). Similarly to the absolute increase, the relative change in maximum strength was relevantly higher in the exergaming group. The mean relative change in maximum strength was 1.7 (SD 1.17) in the intervention group and 1 (SD 0.13) in the control group. No adverse events or problems were reported during the study period. CONCLUSIONS Implementation of an app-based active muscle training program in the early postoperative therapy scheme was associated with an improvement in maximal strength. Therefore, we considered the use of GenuSport training after anterior cruciate ligament reconstruction to be a helpful complement to rehabilitation after anterior cruciate ligament reconstruction surgery to improve strength in the early postoperative phase. To our knowledge this was the first study to analyze immediate postoperative serious gaming-based training with the GenuSport device based on strength improvement.

scholarly journals Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0013
Author(s):  
Fatih Karaaslan ◽  
Sinan Karaoğlu ◽  
Musa Uğur Mermerkaya
Keyword(s):  
Anterior Cruciate Ligament ◽  
Blood Loss ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Control Group ◽  
Double Blind Study ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Objectives: A significant proportion of surgeons use intra-articular drains after arthroscopic anterior cruciate ligament (ACL) reconstruction. Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction. The purpose of the study was to evaluate the effect of tranexamic acid (TXA) administration to minimize pain and stiffness of knee joint by reducing haemarthrosis. Methods: The study enrolled 123 patients who underwent arthroscopic anterior cruciate ligament reconstruction in a prospective, randomized, double-blind study. The patients who were randomized into the TXA group (71 patients) received both intravenous and intra-articular TXA. The control group (52 patients) did not receive TXA. The anesthetist, surgeon, and observer were blinded to the study group (double-blinded). TXA was administered as a bolus dose of 15 mg/kg 10 minutes before the inflation of the tourniquet on the first side. This was followed by continued intra-articular administration of 3 g at 10 minutes before the deflation of the tourniquet. Intravenous infusion of 10 mg/kg/h was continued for the next 3 hours. Equal volumes of placebo were administered at the same rate and by the same route. We measured volume of drained blood 48 hours postoperatively. Results: The mean (± SD) postoperative volume of blood loss from the drain in the TXA and control groups was 100.6 ± 72mL and 164.3 ± 75mL ml, respectively. The difference between the two groups was significant (p < 0.005). Conclusion: This prospective randomized study showed that during arthroscopic anterior cruciate ligament reconstruction, TXA reduced blood loss and helped to reduce haemarthrosis amount and frequency with negligible side effects. With regard to the administration route, combined intravenous–intra-articular administration of TXA significantly reduces blood loss and the need for puncturing associated with arthroscopic anterior cruciate ligament reconstruction without enhancing the risk of deepssssssahrombosis.

scholarly journals Temporal Utilization of Physical Therapy Visits After Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098229
Author(s):  
Patrick J. Burroughs ◽  
Joseph B. Kahan ◽  
Harold G. Moore ◽  
Jonathan N. Grauer ◽  
Elizabeth C. Gardner
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Therapy ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Postoperative Period ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Study Cohort ◽  
Cruciate Ligament Reconstruction ◽  
The Mean ◽  
Anterior Cruciate

Background: Physical therapy (PT) rehabilitation is critical to successful outcomes after anterior cruciate ligament reconstruction (ACLR). Later-stage rehabilitation, including sport-specific exercises, is increasingly recognized for restoring high-level knee function. However, supervised PT visits have historically been concentrated during the early stages of recovery after ACLR. Purpose/Hypothesis: To assess the number and temporal utilization of PT visits after ACLR in a national cohort. We hypothesized that PT visits would be concentrated early in the postoperative period. Study Design: Descriptive epidemiological study. Methods: The Humana PearlDiver database was searched to identify patients who underwent ACLR between 2007 and 2017. Patients with additional structures treated were excluded. The mean ± SD, median and interquartile range (IQR), and range of number of PT visits for each patient were determined for the 52 weeks after ACLR. PT visits over time were also assessed in relation to patient age and sex. Results: In total, 11,518 patients who underwent ACLR met the inclusion criteria; the mean age was 32.62 ± 13.70 years, and 42.7% were female patients. Of this study cohort, 10,381 (90.4%) had documented PT postoperatively; the range of PT visits was 0 to 121. On average, patients had 16.90 ± 10.60 PT visits (median [IQR], 16 [9-22]) after ACLR. Patients completed a mean of 52% of their PT visits in the first 6 weeks, 75% in the first 10 weeks, and 90% in the first 16 weeks after surgery. Patients aged 10 to 19 years had the highest number of PT visits (mean ± SD, 19.67 ± 12.09; median [IQR], 18 [12-25]), significantly greater than other age groups ( P < .001). Conclusion: PT after ACLR is concentrated in the early postoperative period. Physicians, therapists, and patients may consider adjusting the limited access to PT to optimize patient recovery. Clinical Relevance: As supervised PT visits may be limited, the appropriate temporal utilization of supervised PT visits must be maximized. Strategies to ensure sessions for later neuromuscular and activity-specific rehabilitation are needed.

Sign in / Sign up

Export Citation Format

Share Document