scholarly journals Evaluation of Physical Therapy Effectiveness after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 2 (85) ◽  
Author(s):  
Kęstutis Radžiūnas ◽  
Vytenis Trumpickas ◽  
Jonas Poderys
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Therapy Group ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Flexor Muscle ◽  
Therapy Program ◽  
Physical Therapy Program ◽  
Anterior Cruciate

Research background and hypothesis. The aim of physical therapy after sports trauma is to help patients to restore physical activity as it was before injury. The participants who applied for intensive physical therapy after anterior cruciate ligament reconstructive surgery will achieve better leg muscle strength results.Research aim was to compare the effectiveness of intensive and traditional rehabilitation of the knee extensor and flexor muscle strength after the surgery for patients after anterior cruciate ligament reconstruction.Research methods. The method that we used was “Biodex Medical System 3 PRO” for the knee muscle strength. A total of 30 patients were enrolled in this study. The subjects were divided into two groups. The muscle strength was measured while leg was flexed and extended at the knee joint.Research results. The research results showed that participants who received intensive physical therapy program developed better muscle strength than in standard physical therapy group. Participant’s leg muscles recovered faster in intensive physical therapy group than in standard physical therapy group.Discussion and conclusions. The participants who received physical therapy before surgery, electrostimulation and intensive physical therapy program after surgery, achieved higher levels of knee extensor and flexor muscle strength after anterior cruciate ligament reconstructive surgery than those patients undergoing a traditional physical therapy program only after surgery.Keywords: anterior cruciate ligament, intensive physical therapy, muscle strength.

scholarly journals Impact of intensive and traditional rehabilitation on quadriceps strength after anterior cruciate ligament reconstructive surgery

Medicina ◽  
2006 ◽  
Vol 43 (1) ◽  
pp. 51
Author(s):  
Vytautas Streckis ◽  
Albertas Skurvydas ◽  
Pavelas Zachovajevas ◽  
Rimtautas Gudas ◽  
Justė Lukšaitė ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Reconstructive Surgery ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Rehabilitation Program ◽  
Anterior Cruciate ◽  
Knee Extensor Muscle Strength ◽  
Intensive Rehabilitation

After knee anterior cruciate ligament reconstructive surgery, the recovery of the former level of physical activity takes from 3 to 12 months. Such a wide range of recovery period of physical activity suggests that rehabilitation in most cases is not optimal. According to the majority of authors, after the surgery, a patient can resume intensive physical activity, when the difference in muscle strength between the operated lower extremity and another extremity is not greater than 10–15%. The aim of this study was to compare the impact of intensive and normal rehabilitations on the recovery of knee extensor muscle strength after the surgery. Material and methods. A total of 40 patients were enrolled in this study. The subjects were divided into two groups. Both groups were engaged in physical activity. The mean age of patients (16 men and 4 women) in the first group at the time of surgery was 26.4±8.1 years, mean height – 179.8±8.5 cm, and mean weight – 76.0±14.0 kg. An intensive rehabilitation was applied for the first group of the patients studied. The second group consisted of 13 men and 7 women who were engaged in moderate physical activity. Their mean age at the time of surgery was 27.0±9.3 years, mean height – 173.2±6.2 cm, and mean weight – 71.0±9.0 kg. A traditional rehabilitation was applied to this group. Muscle strength was measured in the patients of both groups studied approximately 5.2 months following surgery using the Biodex isokinetic dynamometer. Results. The patients undergoing an intensive rehabilitation achieved higher levels of knee extensor muscle strength than those patients undergoing a traditional rehabilitation program. Applying an aggressive rehabilitation program, knee extensor muscles recover more quickly than using a traditional rehabilitation program. The comparison of intensive and traditional rehabilitation programs applied to the operated and unoperated lower extremities has shown that the indexes of knee extensor muscle strength differed by 11.51– 12.74%. Applying a traditional rehabilitation, a 23.68–49.42% difference in knee flexor muscle strength between operated and unoperated extremities was noted. Conclusions. The effect of intensive rehabilitation aimed at strength recovery of knee extensor muscles after anterior cruciate ligament reconstructive surgery is greater than after ordinary rehabilitation.

scholarly journals Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes

2021 ◽  
pp. 036354652110266
Author(s):  
Keith A. Knurr ◽  
Stephanie A. Kliethermes ◽  
Mikel R. Stiffler-Joachim ◽  
Daniel G. Cobian ◽  
Geoffrey S. Baer ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Collegiate Athletes ◽  
Treadmill Running ◽  
Division I ◽  
P Values ◽  
Peak Knee ◽  
Anterior Cruciate ◽  
Running Biomechanics

Background: Preinjury running biomechanics are an ideal comparator for quantifying recovery after anterior cruciate ligament (ACL) reconstruction (ACLR), allowing for assessments within the surgical and nonsurgical limbs. However, availability of preinjury running biomechanics is rare and has been reported in case studies only. Purpose/Hypothesis: The purpose of this study was to determine if running biomechanics return to preinjury levels within the first year after ACLR among collegiate athletes. We hypothesized that (1) surgical knee biomechanics would be significantly reduced shortly after ACLR and would not return to preinjury levels by 12 months and (2) nonsurgical limb mechanics would change significantly from preinjury. Study Design: Cohort study; Level of evidence, 2. Methods: Thirteen Division I collegiate athletes were identified between 2015 and 2020 (6 female; mean ± SD age, 20.7 ± 1.3 years old) who had whole body kinematics and ground-reaction forces recorded during treadmill running (3.7 ± 0.6 m/s) before sustaining an ACL injury. Running analyses were repeated at 4, 6, 8, and 12 months (4M, 6M, 8M, 12M) after ACLR. Linear mixed effects models were used to assess differences in running biomechanics between post-ACLR time points and preinjury within each limb, reported as Tukey-adjusted P values. Results: When compared with preinjury, the surgical limb displayed significant deficits at all postoperative assessments ( P values <.01; values reported as least squares mean difference [SE]): peak knee flexion angle (4M, 13.2° [1.4°]; 6M, 9.9° [1.4°]; 8M, 9.8° [1.4°]; 12M, 9.0° [1.5°]), peak knee extensor moment (N·m/kg; 4M, 1.32 [0.13]; 6M, 1.04 [0.13]; 8M, 1.04 [0.13]; 12M, 0.87 [0.15]; 38%-57% deficit), and rate of knee extensor moment (N·m/kg/s; 4M, 22.7 [2.4]; 6M, 17.9 [2.3]; 8M, 17.5 [2.4]; 12M, 16.1 [2.6]; 33%-46% deficit). No changes for these variables from preinjury ( P values >.88) were identified in the nonsurgical limb. Conclusion: After ACLR, surgical limb knee running biomechanics were not restored to the preinjury state by 12M, while nonsurgical limb mechanics remained unchanged as compared with preinjury. Collegiate athletes after ACLR demonstrate substantial deficits in running mechanics as compared with preinjury that persist beyond the typical return-to-sport time frame. The nonsurgical knee appears to be a valid reference for recovery of the surgical knee mechanics during running, owing to the lack of change within the nonsurgical limb.

scholarly journals Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0027
Author(s):  
Osman Çiloğlu ◽  
Hakan Çiçek ◽  
Ahmet Yılmaz ◽  
Metin Özalay ◽  
Gökhan Söker ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Surgical Technique ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Tunnel Widening ◽  
Isokinetic Muscle Strength ◽  
Group 2 ◽  
Anterior Cruciate ◽  
Group 1

Objectives: We investigated the effects anatomic or nonanatomic femoral tunnel positions and tunnel fixation methods obtained using two different surgery methods on tunnel widening and clinical results in anterior cruciate ligament (ACL) reconstructions. Methods: Patients with isolated anterior cruciate ligament rupture are included to study who don’t have intra-and extra-articular additional pathology of the knee, without previously a history of operations of both knees. 2 groups were created. Group 1 Aperfix implant were used which can be able to perform non anatomical femoral tunnel and intra tunnel fixation with transtibial technique. In Group 2 Endobutton CL implant were used which can make fixation from outside the cortex with anatomic femoral tunnel in use of anteromedial portal techniques. 27 patients (average age 29,33, range 18 to 55 years) in group 1 and 27 patients (average age 27,51, range 16 to 45 years) in group 2 totally 54 patients were performed surgery. All patients were assessed using the IKDC (International knee documentation committee), Tegner Activity Scala and Lysholm II Functional Scores. Muscle strength measurements in both groups compared to intact knee was measured with an isokinetic dynamometer Biodex System 3 Pro. The location of the femoral tunnel aperture and tunnel widening were imaged with 3D reconstructive computed tomography. All measurements were performed using the same software application by the same radiologist. Results: The two groups were similar with respect to age and sex distribution, operated side, the size of the tunnel created, and follow-up period (p>0.05). After surgery in both groups, the clinical scores showed significant improvement compared to preoperative (p=0,0001). However, postoperative clinical outcomes in the two groups did not show a difference significantly (p>0,005). Isokinetic muscle strength study showed significant differences between the two groups (p=0,0001). Location of femoral tunnel aperture on the medial wall of the lateral femoral condyle showed a significant differences in the two groups (p=0,0001). The expansion of proximal and distal femoral tunnel in two groups showed significant differences (p=0,0001). There was relationship between distal femoral tunnel widening and location of femoral tunnel aperture. Conclusion: Although there is no statistically significant difference between the two groups clinically, difference noticed in terms of isokinetic muscle strength may be due to differences in the degree of shift as a result of multiple loading depending on the biomechanical properties of materials. We thought that the difference seen in the widening of tunnel in the proximal or distal may be due to, the technique of graft fixation, the distance between the fixation point and the joint, and to the location of the femoral tunnel aperture on medial wall of lateral condyle from anatomical or non anatomical region. There is no golden standard in neither surgical technique nor material of fixation. Proper theoretical knowledge and extensive clinical experience are important in the light of an accurate surgical technique applied. We thought that information we have reached in our study should be supported by biomechanical studies

The Role of Patient Characteristics in the Success of Nonoperative Treatment of Anterior Cruciate Ligament Injuries

2020 ◽  
Vol 48 (7) ◽  
pp. 1657-1664 ◽  
Author(s):  
Jelle P. van der List ◽  
Frans J.A. Hagemans ◽  
Dirk Jan Hofstee ◽  
Freerk J. Jonkers
Keyword(s):  
Anterior Cruciate Ligament ◽  
Multivariate Analysis ◽  
Physical Therapy ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Patient Characteristics ◽  
Nonoperative Treatment ◽  
Activity Level ◽  
Acl Injuries ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears can either be treated nonoperatively with physical therapy and then treated operatively if persistent instability is present, or be directly treated operatively. Advantages of early ACL reconstruction surgery include shorter time from injury to surgery and potentially fewer meniscal injuries, but performing early ACL reconstruction in all patients results in surgery in patients who might not need ACL reconstruction. It is important to assess in which patients nonoperative treatment is successful and which patients will require ACL reconstruction and thus might be better treated surgically in an earlier phase. Purpose: To identify patient characteristics that predict the success of nonoperative treatment. Study Design: Cohort study (Prognosis); Level of evidence, 2. Methods: All patients with complete ACL injuries who were evaluated between 2014 and 2017 at our clinic were included. The minimum follow-up was 2 years. The initial treatment and ultimate ACL reconstruction were reviewed. Univariate analysis was performed using Mann-Whitney U tests and chi-square tests and multivariate analysis using binary logistic regression. Results: A total of 448 patients were included with a median age of 26 years and median Tegner level of 7 and mean Tegner level of 6.4. At initial consultation, 210 patients (47%) were treated nonoperatively with physical therapy and 126 of these patients (60%) ultimately required ACL reconstruction. Nonoperative treatment failed in 88.9% of patients <25 years of age, 56.0% of patients 25 to 40 years, and 32.9% of patients >40 years ( P < .001); and 41.9% of patients with Tegner level 3 to 6, and 82.8% of patients with Tegner level 7 to 10. Age <25 years (odds ratio [OR], 7.4; P < .001) and higher Tegner levels (OR, 4.2; P < .001) were predictive of failing nonoperative treatment in multivariate analysis. Patients in the failed nonoperative group had longer time from diagnosis to surgery than the direct reconstruction group (6.2 vs 2.2 months; P < .001), and more frequently had new meniscal injuries (17.4% vs 3.1%; P < .001) at surgery. Conclusion: Nonoperative treatment of ACL injuries failed in 60% of patients and was highly correlated with age and activity level. In patients aged 25 years or younger or participating in higher-impact sports, early ACL reconstruction should be considered to prevent longer delay between injury and surgery, as well as new meniscal injuries.

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