scholarly journals Progressive Rehabilitation of a Professional Soccer Player After an Anterior Cruciate Ligament Reconstruction in Phase 1: Clinical Perspective with Video Demonstration

2021 ◽  
Vol 56 (10) ◽  
pp. 1132-1136
Author(s):  
Francisco Javier Núñez Sánchez ◽  
Francisco Ignacio Martínez Cabrera ◽  
Fernando Hernandez Abad ◽  
Luis Suarez-Arrones

We outline a case of success in the rehabilitation of a Romanian first-division soccer player who sustained an anterior cruciate ligament (ACL) rupture with a meniscal tear during competition in the 2012–2013 season. The ligament was reconstructed with an autologous hamstrings graft and partial meniscectomy was performed. The player returned to same-level competition in 7 months and has remained at that level, free of knee injury, to the present (6 years later). Based on postoperative phase 1 as proposed by the Royal Dutch Society for Physical Therapy, we proposed a clinical progression of exercises with video demonstrations to address body functions and structures and the level of activities and participation. All phase 1 objectives were achieved, and all criteria needed to advance to phase 2 of the ACL rehabilitation process were attained.

2017 ◽  
Vol 52 (11) ◽  
pp. 1079-1083
Author(s):  
Courtney E. Gray ◽  
Chris Hummel ◽  
Todd Lazenby

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.


2016 ◽  
Vol 4 (5) ◽  
pp. 232596711664458 ◽  
Author(s):  
Bertrand Sonnery-Cottet ◽  
Tales Mollica Guimarães ◽  
Matt Daggett ◽  
Jean-Baptiste Pic ◽  
Charles Kajetanek ◽  
...  

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0010
Author(s):  
Brett Heldt ◽  
Elsayed Attia ◽  
Raymond Guo ◽  
Indranil Kushare ◽  
Theodore Shybut

Background: Acute anterior cruciate ligament(ACL) rupture is associated with a significant incidence of concomitant meniscal and chondral injuries. However, to our knowledge, the incidence of these concomitant injuries in skeletally immature(SI) versus skeletally mature(SM) patients has not been directly compared. SI patients are a unique subset of ACL patients because surgical considerations are different, and subsequent re-tear rates are high. However, it is unclear if the rates and types of meniscal and chondral injuries differ. Purpose: The purpose of this study is to compare associated meniscal and chondral injury patterns between SI and SM patients under age 21, treated with ACL reconstruction for an acute ACL tear. We hypothesized that no significant differences would be seen. Methods: We performed a single-center retrospective review of primary ACL reconstructions performed from January 2012 to April 2020. Patients were stratified by skeletal maturity status based on a review of records and imaging. Demographic data was recorded, including age, sex, and BMI. Associated intra-articular meniscal injury, including laterality, location, configuration, and treatment were determined. Articular cartilage injury location, grade, and treatments were determined. Revision rates, non-ACL reoperation rates, and time to surgery were also compared between the two groups. Results: 785 SM and 208 SI patients met inclusion criteria. Mean BMI and mean age were significantly different between groups. Meniscal tear rates were significantly greater in SM versus SI patients in medial meniscus tears(P<.001), medial posterior horn tears(P=.001), medial longitudinal tears configuration(P=.007), lateral Radial configuration(P=.002), and lateral complex tears(P=.011). Medial repairs(P<.001) and lateral partial meniscectomies(P=.004) were more likely in the SM group. There was a significantly greater number of chondral injuries in the SM versus SI groups in the Lateral(p=.007) and medial compartments(P<.001). SM patients had a significantly increased number of outerbridge grade 1 and 2 in the Lateral(P<.001) and Medial Compartments(P=.013). ACL revisions(P=.019) and Non-ACL reoperations(P=.002) were significantly greater in the SI patients compared to SM. No other significant differences were noted. Conclusion: SM ACL injured patients have a significantly higher rate of medial meniscus tears and medial longitudinal configurations treated with repair, and a significantly higher rate of radial and/or complex lateral meniscus tears treated with partial meniscectomy compared to the SI group. We also found a significantly higher rate of both medial and lateral compartment chondral injuries, mainly grades 1 and 2, in SM compared to SI patients. Conversely, SI ACL reconstruction patients had higher revision and subsequent non-ACL surgery rates.


2020 ◽  
Vol 6 (3) ◽  
pp. 368-371
Author(s):  
Julia Demmer ◽  
A. Kitzig ◽  
N. Schlage ◽  
G. Stockmanns ◽  
E. Naroska

AbstractPatients often report an effect after surgery of the anterior cruciate ligament which is called "giving way". This manifest itself by a drop of the knee or a felt instability. This phenomenon is difficult to measure and validate because it usually does not occur regularly and is not reproducible under laboratory conditions. The Knetex project takes up this point by trying to actively support the rehabilitation process with a bandage that can be worn in everyday life and is constructed as a smart textile using sensors and actuators. For this purpose, on the one hand it is attempted to actively record the phenomenon of the "giving way" by measuring knee angles etc. and by active user feedback. At the same time, the patient is specifically advised by means of actuators to correct incorrect posture or movement in order to make the rehabilitation process more effective and prevent further damage. Two 9-axis IMUs (inertial measurement units) form the basis of the system. These are used together with a textile strain sensor to calculate the knee angles. This paper gives an overview of the planned system, the initial experiments to measure the knee angles and the first results of the actuator study.


2021 ◽  
Vol 11 (8) ◽  
pp. 182-193
Author(s):  
Dawid Besztak ◽  
Karina Szczypiór-Piasecka ◽  
Alicja Mińko ◽  
Krzysztof Antczak

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.


Author(s):  
S. M. N. Arosha Senanayake ◽  
Owais Ahmed Malik ◽  
Mohammad Iskandar

The objective of this study is to propose an integrated motion analysis system for monitoring and assisting the rehabilitation process for athletes based on biofeedback mechanism, particularly for human subjects already undergone Anterior Cruciate Ligament (ACL) injury operations and thus about to start the rehabilitation process. For this purpose, different types of parameters (kinematics and neuromuscular signals) from multi-sensors integration are combined to analyze the motion of affected athletes. Signals acquired from sensors are pre-processed in order to prepare the pattern set for intelligent algorithms to be integrated for possible implementation of effective assistive rehabilitation processing tools for athletes and sports orthopedic surgeons. Based on the characteristics of different signals invoked during the rehabilitation process, two different intelligent approaches (Elman RNN and Fuzzy Logic) have been tested. The newly introduced integrated multi-sensors approach will assist in identifying the clinical stage of the recovery process of athletes after ACL repair and will facilitate clinical decision-making during the rehabilitation process. The use of wearable wireless miniature sensors will provide an un-obstructive assessment of the kinematics and neuromuscular changes occurring after ACL reconstruction in an athlete.


2018 ◽  
Vol 43 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Mayank Kalra ◽  
Ryan Bakker ◽  
Sebastian S Tomescu ◽  
Anna M Polak ◽  
Micah Nicholls ◽  
...  

Background: A medial meniscal tear is a common knee injury, especially following an anterior cruciate ligament injury. Decreasing the compressive force on the medial meniscus during dynamic activities using an unloader knee brace could reduce meniscal strain, effectively reducing injury risk and/or severity. Objectives: To investigate the efficacy of two unloader knee braces on medial meniscus strain during dynamic activities in intact & deficient anterior cruciate ligament states. Study design: Combined in vivo/in vitro study. Methods: In vivo knee kinematics and muscle force profiles from a healthy individual performing single/doubleleg squats and walking motions were simulated on 10 cadaveric specimens using a dynamic knee simulator system. Simulations were performed on knees in unbraced and braced scenarios, with and without the anterior cruciate ligament. Anterior and posterior medial meniscal strains were measured. Results: Two different braces each showed a significant reduction in the posteromedial meniscal strain ( p ⩽ 0.01) in an intact anterior cruciate ligament state. Neither brace mirrored this result for the anteromedial strain ( p > 0.05). In the deficient anterior cruciate ligament state, the braces had no significant effect on strain ( p > 0.05). Conclusion: Two unloader knee braces effectively reduced strain in the medial meniscus with an intact anterior cruciate ligament during dynamic activities. Neither brace made a significant reduction in strain for anterior cruciate ligament-deficient knees. Clinical relevance Unloader knee braces could be used to reduce the medial meniscus strain following meniscal surgery and during rehabilitation in patients with an isolated medial meniscus injury. However, these braces cannot be recommended for this purpose in patients with an anterior cruciate ligament deficiency.


2019 ◽  
Vol 33 (03) ◽  
pp. 223-227
Author(s):  
Floris R. van Tol ◽  
Willem A. Kernkamp ◽  
Robert J. P. van der Wal ◽  
Jan-Willem A. Swen ◽  
Samuel K. Van de Velde ◽  
...  

AbstractTwo-stage revision anterior cruciate ligament (ACL) reconstruction is an effective way to revise suboptimal tunnel-placement allowing for proper graft fixation. However, prolonged increased laxity of the knee may increase the risk of meniscal or chondral injury. It was hypothesized that no additional meniscal or chondral lesions occur in between the two stages of the two-stage revision ACL reconstruction. In this retrospective study, 42 patients undergoing a two-stage revision ACL reconstruction were included. Surgical notes for both stages were screened for meniscal and chondral status, interventions to any concurrent injury, surgery dates, along with basic patient characteristics. In 4 of the 42 patients, a new meniscal tear occurred in between the two stages, of which three required partial meniscectomy during the second stage of the ACL revision. One patient experienced a new small degenerative tear that did not require intervention. Two out of the four menisci that were repaired during the first stage had failed and required partial meniscectomy. No significant difference was found in the time between the two stages with respect to the occurrence of meniscal tears. No significant differences in chondral status were found. In conclusion, approximately 10% of patients developed a new meniscal tear and no difference in macroscopic chondral injury was observed between the first and second stages.


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