scholarly journals Comparative Study of Efficacy of Muscle Energy Technique and Positional Release Therapy in Post ACL Reconstruction in Young Adults: A Randomised Clinical Trial

2021 ◽  
pp. 163-167
Author(s):  
Gunjan D. Ingale ◽  
Deepali S. Patil ◽  
Om Wadhokar
Keyword(s):  
Risk Factors ◽  
Range Of Motion ◽  
Acl Reconstruction ◽  
Injury Risk ◽  
Acl Injury ◽  
Anterior Tibial Translation ◽  
Muscle Energy Technique ◽  
Femoral Intercondylar Notch ◽  
Muscle Energy ◽  
Tibial Translation

The anterior cruciate ligament (ACL), it is a dense connective tissue band originating from the medial wall of the lateral femoral condyl and inserts into the middle of the intercondylar region on the tibia. It is regarded as a crucial component in the knee joint because it resists anterior tibial translation and rotational load. Young athletes who participate in sports that demand turning, decelerating, and jumping are at high risk for ACL injury. People who participate in Pivoting sports are likely to have them (e.g. football, basketball, netball, soccer, European team handball, gymnastics, downhill skiing). Environmental (e.g., high friction between shoes and the playing surface) and anatomical variables are also risk factors for ACL injury (e.g. narrow femoral intercondylar notch). Knee instability causes a reduction in activity, which can result in a decrease in knee-related quality of life. ACL injury risk factors have been classified as either internal or external to a person. Type of competition, footwear and surface, and environmental conditions are all external risk factors. Anatomical, hormonal, and neuromuscular risk factors are all internal risk factors. Aim and Objective: to compare the efficacy of Myofacial Release Technique versus Positional Release Therapy on range of motion post ACL reconstruction. Methodology: In this study total 45 patients with post ACL reconstruction will be divided into two groups, one group will receive muscle energy technique and other group will received positional release therapy. The treatment will be given for 5 sessions per week for six weeks. The assessment will be done at day one of treatment at the end of treatment at the end of first week and at the end of six week. Discussion: This study will find the better technique for improving Range of motion Post ACL reconstruction. Conclusion: Conclusion of the study will be drawn after the statistical analysis of the data gathered from the individuals enrolled in the study.

Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women’s Collegiate Soccer

2021 ◽  
pp. 1-8
Author(s):  
Elena M. D’Argenio ◽  
Timothy G. Eckard ◽  
Barnett S. Frank ◽  
William E. Prentice ◽  
Darin A. Padua
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Range Of Motion ◽  
Injury Risk ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Dynamic Risk Factors ◽  
Dynamic Risk ◽  
Anterior Cruciate

Context: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women’s soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Design: Prospective cohort study. Methods: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women’s soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. Results: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Conclusions: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women’s collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.

scholarly journals Excessive anterior tibial translation in the contralateral uninjured limb is significantly associated with ramp lesion in anterior cruciate ligament injury

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Kazuki Asai ◽  
Junsuke Nakase ◽  
Rikuto Yoshimizu ◽  
Mitsuhiro Kimura ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Anterior Tibial Translation ◽  
Ramp Lesion ◽  
Anterior Tibial ◽  
Male Sex ◽  
Anterior Cruciate ◽  
Tibial Translation

Abstract Purpose This study aimed to evaluate the excessive anterior tibial translation (ATT) and muscle strength of patients with ramp lesions. We hypothesised that the higher ATT, lower hamstring-to-quadriceps (HQ) ratio, and higher flexion peak torque influenced by semimembranosus would be associated with ramp lesions. Methods One hundred and twenty-one patients who underwent anterior cruciate ligament (ACL) reconstruction were retrospectively evaluated. Clinical evaluation included ATT of the contralateral uninjured limb measured using a KT-1000 arthrometer, the knee flexor and extensor muscle strength of the contralateral uninjured limb at 60°/s and 180°/s of an angular velocity measured using an isokinetic dynamometer, and HQ ratio at 60°/s and 180°/s during the preoperative state. Binary stepwise logistic regression analysis was performed to evaluate the risk factors of ramp lesions. Results Ramp lesions were found in 27 cases of ACL injuries (27/121, 22.3%). Male sex (odds ratio [OR], 2.913; 95% confidence interval [CI], 1.090–7.787; P = 0.033), longer time between injury to surgery (OR, 2.225; 95% CI, 1.074–4.608; P = 0.031), and higher ATT in the contralateral uninjured limb (OR, 1.502; 95% CI, 1.046–2.159; P = 0.028) were indicated as the independent risk factors of the presence of ramp lesion associated with an ACL injury. Conclusions Male sex, longer period from injury to surgery, and higher ATT in the contralateral uninjured limb were significantly associated with ramp lesion. These findings are advantageous for identifying patients with a greater risk of developing a ramp lesion with an ACL injury in the clinical setting. Level of evidence Level IV

Detailed Cadaveric Simulation of Landing Reveals Timing Sequence of Multi-Planar Knee Kinematics: Implications for ACL Injury

2013 ◽  
Author(s):  
A. M. Kiapour ◽  
C. E. Quatman ◽  
V. K. Goel ◽  
S. C. Wordeman ◽  
T. E. Hewett ◽  
...  
Keyword(s):  
Injury Risk ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Acl Injury ◽  
The United States ◽  
Anterior Tibial Translation ◽  
Tibial Rotation ◽  
Acl Injuries ◽  
Cadaveric Simulation ◽  
Tibial Translation

Over 120,000 anterior cruciate ligament (ACL) injuries occur annually in the United States, mainly affecting the young athletic population. Non-contact injuries are reported to be the predominant mechanism of ACL injury (>70% of ACL injuries), which often occur during landing with high ground reaction forces, muscle forces and segmental inertia. An improved understanding of the mechanisms underlying non-contact ACL injury and inciting events can be used to improve current prevention strategies and decrease the risk of early-onset osteoarthritis. Previous biomechanical and video analysis studies have demonstrated that anterior tibial translation (ATT), knee valgus and internal tibial rotation (ITR) are associated with non-contact ACL injuries [1–3]. While the effects of these factors on ACL injury risk have been extensively studied, there is still controversy and debate about the timing in which these motions occur and reach maximum values during a jump landing task. The current study aimed to investigate interactions between tibio-femoral joint kinematics and ACL strain through a detailed cadaveric simulation of the knee biomechanical response during landing from a jump. For this purpose, instrumented cadaveric limbs were used to simulate bi-pedal landing following a jump utilizing a novel testing apparatus.

Is Remnant Preservation Truly Beneficial to Anterior Cruciate Ligament Reconstruction Healing? Clinical and Magnetic Resonance Imaging Evaluations of Remnant-Preserved Reconstruction

2017 ◽  
Vol 45 (5) ◽  
pp. 1049-1058 ◽  
Author(s):  
Takuya Naraoka ◽  
Yuka Kimura ◽  
Eiichi Tsuda ◽  
Yuji Yamamoto ◽  
Yasuyuki Ishibashi
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Anterior Tibial Translation ◽  
Resonance Imaging ◽  
Graft Incorporation ◽  
Remnant Preservation ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation

Background: Remnant-preserved anterior cruciate ligament (ACL) reconstruction was introduced to improve clinical outcomes and biological healing. However, the effects of remnant preservation and the influence of the delay from injury until reconstruction on the outcomes of this technique are still uncertain. Purpose/Hypothesis: The purposes of this study were to evaluate whether remnant preservation improved the clinical outcomes and graft incorporation of ACL reconstruction and to examine the influence of the delay between ACL injury and reconstruction on the usefulness of remnant preservation. We hypothesized that remnant preservation improves clinical results and accelerates graft incorporation and that its effect is dependent on the delay between ACL injury and reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 151 consecutive patients who underwent double-bundle ACL reconstruction using a semitendinosus graft were enrolled in this study: 74 knees underwent ACL reconstruction without a remnant (or the remnant was <25% of the intra-articular portion of the graft; NR group), while 77 knees underwent ACL reconstruction with remnant preservation (RP group). These were divided into 4 subgroups based on the time from injury to surgery: phase 1 was <3 weeks (n = 24), phase 2 was 3 to less than 8 weeks (n = 70), phase 3 was 8 to 20 weeks (n = 32), and phase 4 was >20 weeks (n = 25). Clinical measurements, including KT-1000 arthrometer side-to-side anterior tibial translation measurements, were assessed at 3, 6, 12, and 24 months after reconstruction. Magnetic resonance imaging evaluations of graft maturation and graft-tunnel integration of the anteromedial and posterolateral bundles were assessed at 3, 6, and 12 months after reconstruction. Results: There was no difference in side-to-side anterior tibial translation between the NR and RP groups. There was also no difference in graft maturation between the 2 groups. Furthermore, the time from ACL injury until reconstruction did not affect graft maturation, except in the case of very long delays before reconstruction (phase 4). Graft-tunnel integration was significantly increased in both groups in a time-dependent manner. However, there was no difference between the NR and RP groups. Conclusion: Remnant preservation did not improve knee stability at 2 years after ACL reconstruction. Furthermore, remnant preservation did not accelerate graft incorporation, especially during the acute and subacute injury phases.

Predictive Value of the Magnetic Resonance Imaging–Based Coronal Lateral Collateral Ligament Sign on Adolescent Anterior Cruciate Ligament Reconstruction Graft Failure

2021 ◽  
Vol 49 (4) ◽  
pp. 935-940
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Tracey Bastrom ◽  
James D. Bomar ◽  
Andrew T. Pennock ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Acl Reconstruction ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Anterior Tibial Translation ◽  
Complex Injury ◽  
Patient Reported ◽  
Anterolateral Complex ◽  
Tibial Translation

Background: The coronal lateral collateral ligament (LCL) sign is the presence of the full length of the LCL visualized on a single coronal magnetic resonance imaging (MRI) slice at the posterolateral corner of the knee. The coronal LCL sign has been shown to be associated with elevated measures of anterior tibial translation and internal rotation in the setting of anterior cruciate ligament (ACL) tear. Hypothesis: The coronal LCL sign (with greater anterior translation, internal rotation, and posterior slope of the tibia) will indicate a greater risk for graft failure after ACL reconstructive surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Retrospective review was performed of adolescent patients with ACL reconstruction: a cohort without graft failure and a cohort with graft failure. MRI was utilized to measure tibial translation and femorotibial rotation and to identify the coronal LCL sign. The posterior tibial slope was measured on lateral radiographs. Patient-reported outcomes were collected. Results: We identified 114 patients with no graft failure and 39 patients with graft failure who met all criteria, with a mean follow-up time of 3.5 years (range, 2-9.4 years). Anterior tibial translation was associated with anterolateral complex injury ( P < .001) but not graft failure ( P = .06). Internal tibial rotation was associated with anterolateral complex injury ( P < .001) and graft failure ( P = .042). Posterior tibial slope was associated with graft failure ( P = .044). The coronal LCL sign was associated with anterolateral complex injury ( P < .001) and graft failure ( P = .013), with an odds ratio of 4.3 for graft failure (95% CI, 1.6-11.6; P = .003). Subjective patient-reported outcomes and return to previous level of sport were not associated with failure. Comparison of MRI before and after ACL reconstruction in the graft failure cohort demonstrated a reduced value in internal rotation ( P = .003) but no change in coronal LCL sign ( P = .922). Conclusion: Our study demonstrates that tibial internal rotation and posterior slope are independent predictors of ACL graft failure in adolescents. Although the value of internal rotation could be improved with ACL reconstruction, the presence of the coronal LCL sign persisted over time and was predictive of graft rupture (without the need to make measurements or memorize values of significant risk). Together, these factors indicate that greater initial knee deformity after initial ACL tear predicts greater risk for future graft failure.

scholarly journals Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1035
Author(s):  
Eva-Maria Winkelmeyer ◽  
Justus Schock ◽  
Lena Marie Wollschläger ◽  
Philipp Schad ◽  
Marc Sebastian Huppertz ◽  
...  
Keyword(s):  
Knee Joint ◽  
Imaging Modality ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Anterior Tibial Translation ◽  
Joint Stability ◽  
Anatomic Landmarks ◽  
Human Knee Joint ◽  
Custom Made ◽  
Tibial Translation

While providing the reference imaging modality for joint pathologies, MRI is focused on morphology and static configurations, thereby not fully exploiting the modality’s diagnostic capabilities. This study aimed to assess the diagnostic value of stress MRI combining imaging and loading in differentiating partial versus complete anterior cruciate ligament (ACL)-injury. Ten human cadaveric knee joint specimens were subjected to serial imaging using a 3.0T MRI scanner and a custom-made pressure-controlled loading device. Emulating the anterior-drawer test, joints were imaged before and after arthroscopic partial and complete ACL transection in the unloaded and loaded configurations using morphologic sequences. Following manual segmentations and registration of anatomic landmarks, two 3D vectors were computed between anatomic landmarks and registered coordinates. Loading-induced changes were quantified as vector lengths, angles, and projections on the x-, y-, and z-axis, related to the intact unloaded configuration, and referenced to manual measurements. Vector lengths and projections significantly increased with loading and increasing ACL injury and indicated multidimensional changes. Manual measurements confirmed gradually increasing anterior tibial translation. Beyond imaging of ligament structure and functionality, stress MRI techniques can quantify joint stability to differentiate partial and complete ACL injury and, possibly, compare surgical procedures and monitor treatment outcomes.

The Effects of Muscle Energy Technique on Cervical Range of Motion

1994 ◽  
Vol 2 (4) ◽  
pp. 149-155 ◽  
Author(s):  
Ronald Schenk ◽  
Kimberly Adelman ◽  
John Rousselle
Keyword(s):  
Range Of Motion ◽  
Cervical Range Of Motion ◽  
Muscle Energy Technique ◽  
Muscle Energy

scholarly journals Efficacy of spinal extension exercise program versus muscle energy technique in treatment of chronic mechanical low back pain

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
E. Fahmy ◽  
H. Shaker ◽  
W. Ragab ◽  
H. Helmy ◽  
M. Gaber
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Range Of Motion ◽  
Functional Disability ◽  
Exercise Program ◽  
Low Back ◽  
Muscle Energy Technique ◽  
Muscle Energy ◽  
Group B ◽  
Lumbar Range Of Motion

Abstract Background Mechanical low back pain (MLBP) is a major cause of illness and disability, especially in people of working age. People with chronic low back pain often experience anger, fear, anxiety, decrease in physical ability, and inadequacy of role fulfillment. Objective This study aimed to compare the efficacy of extension exercise program versus muscle energy technique in treating patients with chronic mechanical low back pain. Subjects and methods Forty patients complaining of chronic mechanical low back pain participated in the study. Patients were randomly allocated into two equal groups: group A which received spinal extension exercise program and group B which received muscle energy technique. Treatment sessions were given three times per week for four successive weeks. Patients were assessed before and after treatment using visual analogue scale (VAS), Oswestry Disability Index (ODI), and digital goniometer to assess pain intensity, functional disability, and range of motion (ROM) of lumbar spine respectively. Results There was significant decrease in the scores of pain and functional disability in both groups post-treatment especially in group B. There was significant increase in lumbar range of motion in both groups post-treatment, especially in group A. Conclusion Extension exercise program had better effect on improving lumbar range of motion, whereas muscle energy technique was better in decreasing pain and functional disability in patients with chronic mechanical low back pain.

scholarly journals A Cam Shaped Femur Might Be A Risk Factor for ACL Injuries

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0013
Author(s):  
Thomas Rudolf Pfeiffer ◽  
Jeremy M. Burnham ◽  
Ajay C. Kanakamedala ◽  
Jonathan Daniel Hughes ◽  
James J. Irrgang ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Injury Risk ◽  
Roc Analysis ◽  
Femoral Condyle ◽  
Academic Medical Center ◽  
Acl Injury ◽  
Control Group ◽  
Acl Injuries ◽  
Increased Risk ◽  
The Mean

Objectives: Bony morphologic characteristics have been demonstrated to increase the risk of anterior cruciate ligament (ACL) injury. While posterior femoral condyle condylar offset is an aspect of distal femoral bony morphology that has been reported to influence range of motion and other aspects of knee joint kinematics, it remains unclear whether this characteristic influences the risk of ACL injury. The purpose of the study was to examine the relationship between distal femoral morphology and risks of ACL injury, reconstruction failure, and contralateral ACL injury. It was hypothesized that increased posterior femoral condylar depth, quantified as the cam ratio, would correlate with increased risk of primary ACL injuries, ACL reconstruction failures, and contralateral ACL injuries. Methods: Consecutive patients undergoing evaluation for knee complaints at an academic medical center from 2012-2016 with minimum 24-month follow-up were retrospectively reviewed. Subjects were stratified into four groups: a control group consisting of patients with no ACL injuries and three groups of patients with a primary ACL injury, failed ACL reconstruction, or previous ACL injury with subsequent contralateral ACL injury. Using lateral radiographs, the ratio of posterior condylar depth over total condylar distance was defined as the cam ratio. Analysis-of-variance (ANOVA) and post-hoc testing were used to test for differences in the mean tomahawk ratio between study groups (p<0.05). Receiver Operating Characteristic (ROC) analysis was performed to determine the optimal cam ratio cut-off for detecting increased risk for ACL injury. Results: One hundred and seventy-five patients met inclusion criteria. The mean cam ratios in the control, primary ACL injury, failed ACL reconstruction, and contralateral ACL injury groups were 61.1% (± 2.1), 64.2% (± 3.8), 64.4% (± 3.6), and 66.9% (± 4.0), respectively. Patients with a primary ACL injury, failed ACL reconstruction, or contralateral ACL injury had a significantly higher cam ratio compared to the control group (p<0.008). ROC analysis demonstrated a cam ratio of 63% or greater to be associated with an increased risk for ACL injury with a sensitivity of83% and a specificity of 71%. Conclusion: The data from this study show that an increased posterior femoral condylar depth, or cam ratio, might be associated with increased risk of ACL injury, including primary ACL injury, failed ACL reconstruction, and contralateral ACL injury. The data from this study may help clinicians identify patients at greater risk of ACL injury and re-injury. Future prospective studies will be helpful in investigating the mechanism by which an increased cam ratio increases ACL injury risk and potential strategies to mitigate the increased risk posed by this bony characteristic.

scholarly journals Longitudinal Assessment of Noncontact Anterior Cruciate Ligament Injury Risk Factors During Maturation in a Female Athlete: A Case Report

2009 ◽  
Vol 44 (1) ◽  
pp. 101-109 ◽  
Author(s):  
Gregory D. Myer ◽  
Kevin R. Ford ◽  
Jon G. Divine ◽  
Eric J. Wall ◽  
Leamor Kahanov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Body Mass ◽  
Female Athlete ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Knee Abduction ◽  
Injury Risk Factors ◽  
Anterior Cruciate

Abstract Objective: To present a unique case of a young pubertal female athlete who was prospectively monitored for previously identified anterior cruciate ligament (ACL) injury risk factors for 3 years before sustaining an ACL injury. Background: In prospective studies, previous investigators have examined cross-sectional measures of anatomic, hormonal, and biomechanical risk factors for ACL injury in young female athletes. In this report, we offer a longitudinal example of measured risk factors as the participant matured. Differential Diagnosis: Partial or complete tear of the ACL. Measurements: The participant was identified from a cohort monitored from 2002 until 2007. No injury prevention training or intervention was included during this time in the study cohort. Findings: The injury occurred in the year after the third assessment during the athlete's club basketball season. Knee examination, magnetic resonance imaging findings, and arthroscopic evaluation confirmed a complete ACL rupture. The athlete was early pubertal in year 1 of the study and pubertal during the next 2 years; menarche occurred at age 12 years. At the time of injury, she was 14.25 years old and postpubertal, with closing femoral and tibial physes. For each of the 3 years before injury, she demonstrated incremental increases in height, body mass index, and anterior knee laxity. She also displayed decreased hip abduction and knee flexor strength, concomitant with increased knee abduction loads, after each year of growth. Conclusions: During puberty, the participant increased body mass and height of the center of mass without matching increases in hip and knee strength. The lack of strength and neuromuscular adaptation to match the increased demands of her pubertal stature may underlie the increased knee abduction loads measured at each annual visit and may have predisposed her to increased risk of ACL injury.

Sign in / Sign up

Export Citation Format

Share Document