Guideline on anterior cruciate ligament injury

Meuffels, Duncan E.; Poldervaart, Michelle T.; Diercks, Ron L.; Fievez, Alex W F M; Patt, Thomas W; Hart, Cor P. van der; Hammacher, E.R.; Meer, Fred van der; Goedhart, Edwin A; Lenssen, Antoine F.; Muller-Ploeger, Sabrina B; Pols, Margreet A.; Saris, Daniël B.F.

doi:10.3109/17453674.2012.704563

Cited by 89 publications

(93 citation statements)

References 79 publications

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“…This supports previous studies that have identified activity demands and instability as important factors [18–20]. Orthopaedic surgeons considered that a physically demanding occupation was a very important factor for recommending surgery (grading “3” twice as many times compared to “2”).…”

Section: Discussionsupporting

confidence: 87%

Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction

Grevnerts

Fältström

Sonesson

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of the study was to (1) study and compare the factors that Swedish orthopaedic surgeons and physical therapists consider important for recommending ACL reconstruction and, (2) to assess how orthopaedic surgeons and physical therapists consider their own and each others, as well as patients’, roles are in the treatment decision.MethodsA web-based survey assessing the relevance of 21 predetermined factors, in the choice to recommend ACL reconstruction, was sent to orthopaedic surgeons and physical therapists. Respondents were also asked to rate the importance of the assessment made by themselves, the other clinician (physical therapists rated the importance of surgeons, surgeons rated the importance of physical therapists), and the patients’ preferences.ResultOrthopaedic surgeons agreed of eight, and physical therapists of seven factors as important in the choice to recommend ACL reconstruction. The factors both groups reported as important were; “patient’s wishes to return to contact/pivoting sports”, “instability in physical activity”, “instability in activities of daily living despite adequate rehabilitation”, “physically demanding occupation”, and “young age”. Both professions rated their own and each others assessments as well as patient’s wishes as important for the decision to recommend ACL reconstruction.ConclusionOrthopaedic surgeons and physical therapists agree about factors that are important for their decision to recommend ACL reconstruction, showing that both professions share a common ground in perceptions of factors that are important in recommending ACL reconstruction.Level of evidenceDiagnostic study: Level III.Electronic supplementary materialThe online version of this article (10.1007/s00167-018-4846-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction

Grevnerts

Fältström

Sonesson

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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“…They recommended the use of a combination of physical examination using Lachman, pivot shift and anterior drawer tests, level 1 evidence, together with the following outcome scores-International Knee Documentation Committee Subjective Knee Evaluation Form Score (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS) or Tegner Score from level 2 evidence [21] .…”

Section: Discussionmentioning

confidence: 99%

Anterior cruciate ligament reconstruction best practice: A review of graft choice

Shaerf

Pastides

Sarraf

et al. 2014

WJO

119

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There is much literature about differing grafts used in anterior cruciate ligament (ACL) reconstruction. Much of this is of poor quality and of a low evidence base. We review and summarise the literature looking at the four main classes of grafts used in ACL reconstruction; bone-patella tendon-bone, hamstrings, allograft and synthetic grafts. Each graft has the evidence for its use reviewed and then compared, where possible, to the others. We conclude that although there is no clear "best" graft, there are clear differences between the differing graft choices. Surgeon's need to be aware of the evidence behind these differences, in order to have appropriate discussions with their patients, so as to come to an informed choice of graft type to best suit each individual patient and their requirements.

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“…Patients that are active in pivoting sports are more likely to successfully return to the initial sport when treated by ACL reconstruction as compared with conservative therapy [12, 13]. Furthermore, ACL reconstruction is recommended if patients complain of knee instability in common daily activities and work [14]. Optimal timing for an ACL reconstruction is when the range of knee motion has normalized and the synovial reaction in the knee has diminished [2, 12, 14].…”

Section: Introductionmentioning

confidence: 99%

Beneficial and limiting factors for return to work following anterior cruciate ligament reconstruction: a retrospective cohort study

Groot

Jonkers

Kievit

et al. 2016

Arch Orthop Trauma Surg

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PurposeEvidence-based advice for return to work (RTW) after anterior cruciate ligament (ACL) reconstruction is not available. Therefore, the objectives of this study were to determine when patients achieve full RTW, and to explore the beneficial and limiting factors for fully RTW after ACL reconstruction.MethodsA retrospective cohort study was performed after ACL reconstruction among 185 patients in one hospital. Data from patient files and a questionnaire were used to explore whether patient-, injury-, surgery-, sports-, work- and rehabilitation-related factors are beneficial or limiting for fully RTW after ACL reconstruction, using a backward stepwise logistic regression analysis.ResultsOf the 125 (68%) patients that returned the questionnaire, 36 were not part of the working population. Of the remaining 89 patients, 82 patients (92%) had returned fully to work at follow-up. The median time to fully RTW was 78 days. In the final regression model, which explained 29% of the variance, a significant OR of 5.4 (90% CI 2.2–13.1) for RTW > 78 days was observed for patients performing heavy knee-demanding work compared to patients performing light knee-demanding work. In addition, a significant and positive OR (1.6, 90% CI 1.2–1.9) for the number of weeks walking with the aid of crutches for RTW > 78 days was observed in the final model.ConclusionAfter ACL reconstruction, 92% of the patients fully return to work at a median time of 78 days. The significant predictors for fully RTW > 78 days are performing heavy knee-demanding work and a longer period of walking aided with crutches after ACL reconstruction.

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Guideline on anterior cruciate ligament injury

Cited by 89 publications

References 79 publications

Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction

Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction

Anterior cruciate ligament reconstruction best practice: A review of graft choice

Beneficial and limiting factors for return to work following anterior cruciate ligament reconstruction: a retrospective cohort study

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