Functional Bracing after Anterior Cruciate Ligament Reconstruction

McDevitt, Edward R.; Taylor, Dean C.; Miller, Mark D.; Gerber, J. Parry; Ziemke, Gregg; Hinkin, Daniel T.; Uhorchak, John M.; Arciero, Robert A.; Pierre, Patrick St.

doi:10.1177/0363546504265998

Cited by 103 publications

(58 citation statements)

References 16 publications

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“…ACLR, anterior cruciate ligament reconstruction. b References 1 , 4 , 7 , 8 , 10 , 11 , 16 , 19 , 27 , 30 , 33 , 36 , 43 – 46 , 52 – 56 , 59 , 60 , 63 , 72 , 76 , 79 , 80 , 84 , 85 , 89 , 95 , 98 , 99 , 107 . c References 3 , 8 , 16 , 27 , 30 , 39 , 44 , 51 , 60 , 72 , 80 , 83 , 89 .…”

Section: Resultsunclassified

Functional Performance Testing After Anterior Cruciate Ligament Reconstruction

Abrams

Harris

Gupta

et al. 2014

Orthopaedic Journal of Sports Medicine

203

182

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Background:When to allow an athlete to return to unrestricted sporting activity after anterior cruciate ligament (ACL) reconstruction remains controversial.Purpose:To report the results of functional performance testing reported in the literature for individuals at differing time points following ACL reconstruction and to examine differences between graft types.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review of Medline, Scopus, and Cochrane Central Register of Controlled Trials was performed using PRISMA guidelines. Inclusion criteria were English-language studies that examined any functional rehabilitation test from 6 months to 2 years following ACL reconstruction. All patient-, limb-, and knee-specific demographics were extracted from included investigations. All functional rehabilitation tests were analyzed and compared when applicable.Results:The search term returned a total of 890 potential studies, with 88 meeting inclusion and exclusion criteria. A total of 4927 patients were included, of which 66% were male. The mean patient age was 26.5 ± 3.4 years. The predominant graft choices for reconstruction were bone–patellar tendon–bone (BPTB) autograft (59.8%) and hamstring autograft (37.9%). The most commonly reported functional tests were the hop tests. The results of these functional tests, as reported in the Limb Symmetry Index (LSI), improved with increasing time, with nearly all results greater than 90% at 1 year following primary ACL reconstruction. At 6 months postoperatively, a number of isokinetic strength measurements failed to reach 80% LSI, most commonly isokinetic knee extension testing in both BPTB and hamstring autograft groups. The knee flexion strength deficit was significantly less in the BPTB autograft group as compared with those having hamstring autograft at 1 year postoperatively, while no significant differences were found in isokinetic extension strength between the 2 groups.Conclusion:Hop testing was the most commonly reported functional test following ACL reconstruction. Increases in performance on functional tests were predictably seen as time increased following surgery. Those with hamstring autografts may experience increased strength deficits with knee flexion versus those having BPTB autograft. These data provide information that may assist providers in determining timing of return to unrestricted sporting activity.

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Section: Resultsunclassified

Functional Performance Testing After Anterior Cruciate Ligament Reconstruction

Abrams

Harris

Gupta

et al. 2014

Orthopaedic Journal of Sports Medicine

203

182

View full text Add to dashboard Cite

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“…When reviewing the literature regarding return-to-sport outcomes, wide variation in return-to-sport rates can be seen—from 100% in some studies 12 , 18 , 40 , 42 to as low as 20% in others. 7 , 52 , 54 , 56 The results of the most recent meta-analysis of return-to-sport rates (based on data from 69 articles and 7556 participants) illustrated the importance of reporting the level of participation when evaluating returning to sport.…”

Section: How Many People Return To Sport After Acl Reconstruction?mentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction—Not Exactly a One-Way Ticket Back to the Preinjury Level

Ardern

2015

Sports Health: A Multidisciplinary Approach

139

100

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Context:A recently updated meta-analysis of return-to-sport rates after anterior cruciate ligament (ACL) reconstruction demonstrated that 65% of athletes returned to their preinjury level of sport after surgery. The aim of this clinical review was to explore contextual factors associated with returning or not returning to the preinjury level after ACL reconstruction.Evidence Acquisition:Data were obtained from peer-reviewed literature via a search of the electronic databases Medline, Embase, CINAHL, and SPORTDiscus from database inception to January 2015. The keywords anterior cruciate ligament and return to sport were used. Additional literature was identified via hand-searching of the reference lists of relevant articles and the ePublication lists of key scientific journals. Random effects meta-analyses were used to pool the results of modifiable contextual factors and to examine their association with returning or not returning to the preinjury level of sport after surgery.Study Design:Clinical review.Level of Evidence:Level 2.Results:Lower fear of reinjury (standardized mean difference, 0.7), greater psychological readiness to return to sport (standardized mean difference, 1.0), and a more positive subjective assessment of knee function (standardized mean difference, 0.9) favored return to the preinjury level after surgery.Conclusion:Returning or not returning to the preinjury level after ACL reconstruction is complex and multifactorial. Screening for potentially modifiable contextual factors, particularly psychological factors, early after ACL injury may help clinicians identify athletes who could be at risk of not returning to the preinjury level of sport and institute interventions that could improve returning to sport.

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“…I McDevitt et al 105 prospectively followed 100 service academy candidates with ACL reconstruction. Patients were randomly assigned to a braced or non-braced group.…”

Section: Clinical Guidelines: Interventionsmentioning

confidence: 99%

Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain

Logerstedt¹,

Snyder‐Mackler²,

Ritter³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

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The Orthopaedic Section of the American Physical Therapy Association presents this fourth set of clinical practice guidelines on knee ligament sprain, linked to the International Classification of Functioning, Disability, and Health (ICF). The purpose of these practice guidelines is to describe evidence-based orthopaedic physical therapy clinical practice and provide recommendations for (1) examination and diagnostic classification based on body functions and body structures, activity limitations, and participation restrictions, (2) interventions provided by physical therapists, (3) and assessment of outcome for common musculoskeletal disorders. J Orthop Sports Phys Ther 2010;40(4):A1–A37. doi:10.2519/jospt.2010.0303

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Functional Bracing after Anterior Cruciate Ligament Reconstruction

Abstract: In this young, active population, postoperative bracing does not appear to change the clinical outcomes after anterior cruciate ligament reconstruction.

Cited by 103 publications

References 16 publications

Functional Performance Testing After Anterior Cruciate Ligament Reconstruction

Functional Performance Testing After Anterior Cruciate Ligament Reconstruction

Anterior Cruciate Ligament Reconstruction—Not Exactly a One-Way Ticket Back to the Preinjury Level

Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain

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