Preoperative anterior knee laxity did not influence postoperative stability restored by anterior cruciate ligament reconstruction

Study Design:Prospective randomized clinical trial.Methods and Measures:Thirty-six patients who had a primary anterior cruciate ligament reconstruction (ACL-R) with a semitendinosus-gracilis (STG) autograft from a single orthopedic surgeon were prospectively randomized into 2 groups. Nineteen patients were randomized to the aggressive group (53% male, mean age 30.1 + 10.5 y) and 17 to the nonaggressive group (88% male, mean age 33.1 + 10.9 y). Impairment measures of anteroposterior (A-P) knee laxity, range of motion (ROM), and peak isometric force (PIF) values were obtained 12 wk postoperatively. Subjective response to the International Knee Documentation Committee knee form (IKDC) was collected 1, 12, and 24 wk postoperatively. One-way ANOVA was used to analyze differences between groups at 12 wk for A-P knee laxity, ROM, and PIF. Differences between the groups for the IKDC scores were determined using 1-way ANOVA with repeated measures 1, 12, and 24 wk postoperatively. Bonferroni adjustment was used for multiple comparisons.Results:There were no differences between the groups for the baseline characteristics (P > .05). There was no difference found between the groups in respect to A-P knee laxity, ROM, or PIF at 12 wk (P > .05). Further analysis also showed no significant differences in the IKDC scores between groups at 12 or 24 wk (P > .05).Conclusions:No differences were found between early aggressive and nonaggressive rehabilitation after an isolated ACL-R using STG autografts for the primary outcomes of A-P knee laxity and subjective IKDC score. In addition, no differences were observed for secondary outcomes between groups for differences in ROM and PIF values.

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Anterior knee pain 7 years after an anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft

Scandinavian Journal of Medicine and Science in Sports ◽

10.1034/j.1600-0838.2000.010004221.x ◽

2000 ◽

Vol 10 (4) ◽

pp. 221-227 ◽

Cited By ~ 39

Author(s):

T. Järvelä ◽

P. Kannus ◽

M. Järvinen

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Anterior Knee Pain ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate ◽

Bone Autograft ◽

Anterior Knee ◽

Bone Patellar Tendon

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Rehabilitation after Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized, Double-Blind Comparison of Programs Administered over 2 Different Time Intervals

The American Journal of Sports Medicine ◽

10.1177/0363546504268406 ◽

2005 ◽

Vol 33 (3) ◽

pp. 347-359 ◽

Cited By ~ 162

Author(s):

Bruce D. Beynnon ◽

Benjamin S. Uh ◽

Robert J. Johnson ◽

Joseph A. Abate ◽

Claude E. Nichols ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Patient Satisfaction ◽

Anterior Cruciate Ligament Reconstruction ◽

Clinical Assessment ◽

Ligament Reconstruction ◽

Functional Performance ◽

Cruciate Ligament ◽

Knee Laxity ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

Background There are adverse effects associated with immobilization of the knee after anterior cruciate ligament reconstruction, yet very little is known about how much activity will promote adequate rehabilitation without permanently elongating the graft, producing graft failure, or creating damage to articular cartilage. Hypothesis Rehabilitation with either an accelerated or nonaccelerated program produces no difference in anterior-posterior knee laxity, clinical assessment, patient satisfaction, functional performance, and the synovial fluid biomarkers of articular cartilage metabolism. Study Design Randomized controlled clinical trial; Level of evidence, 1. Methods Twenty-five patients who tore their anterior cruciate ligament were enrolled and underwent anterior cruciate ligament reconstruction. Patients were randomized to accelerated rehabilitation or nonaccelerated rehabilitation. At the time of surgery and 3, 6, 12, and 24 months later, measurements of anterior-posterior knee laxity, clinical assessment, patient satisfaction, functional performance, and cartilage metabolism were completed. Results At the 2-year follow-up, there was no difference in the increase of anterior knee laxity relative to the baseline values that were obtained immediately after surgery between the 2 groups (2.2-mm vs 1.8-mm increase relative to the normal knee). The groups were similar in terms of clinical assessment, patient satisfaction, activity level, function, and response of the bio-markers. After 1 year of healing, synthesis of collagen and turnover of aggrecan remained elevated in both groups. Conclusion Anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft followed by either accelerated or nonaccelerated rehabilitation produces the same increase of anterior knee laxity. Both programs had the same effect in terms of clinical assessment, patient satisfaction, functional performance, and the biomarkers of articular cartilage metabolism. There is concern that the cartilage biomarkers remained elevated for an extended period.

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