Recent Advances in the Rehabilitation of Anterior Cruciate Ligament Injuries

Wilk, Kevin E.; Macrina, Leonard C.; Cain, E. Lyle; Dugas, Jeffrey R.; Andrews, James R.

doi:10.2519/jospt.2012.3741

Cited by 136 publications

(137 citation statements)

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“…8,10,[43][44][45] Several researchers 2,39 concluded that aberrant weakness preoperatively is associated with poorer functional outcomes at 6 months after surgery. Although factors including swelling, pain, muscular inhibition, and mobility deficits directly affect postoperative muscle function, 46 previous work 42,47,48 has indicated that early resistive muscle overloading promotes more optimal strength and volume, which in turn is associated with improved self-reported outcomes. Our findings show an association between lower extremity strength and patientreported function, further promoting the idea that early muscular strength training prevents atrophy and improves self-reported outcomes after ACLR.…”

Section: Discussionmentioning

confidence: 99%

What Can the First 2 Months Tell Us About Outcomes After Anterior Cruciate Ligament Reconstruction?

Christensen

Goldfine²,

Barker

et al. 2015

Journal of Athletic Training

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Context: Substantial research has been conducted on anterior cruciate ligament reconstruction (ACLR) to evaluate patient outcomes. However, little attention has been given to outcomes during the early phase of recovery and how early deficits affect both short-and long-term outcomes.Objective: To identify relationships between demographic (age, sex, and body mass index [BMI]) and intraoperative (isolated ACLR versus primary ACLR þ secondary procedures), and postoperative (range-of-motion [ROM] and peak isometric knee-extension force [PIF]) variables during the first 2 months after ACLR using self-reported outcomes.Design: Cohort study. Results: Significant relationships were identified between !12-month IKDC scores and the 1-month (Pearson correlation, r ¼ 0.283, r 2 ¼ 0.08; P ¼ .025) and 2-month (r ¼ 0.301, r 2 ¼ 0.09; P ¼ .017) IKDC scores. After controlling for other variables, we found that the PIF ratio measures at 1 and 2 months were positively associated with 1-and 2-month IKDC scores (P , .001) and BMI was negatively associated with both 1-and 2-month IKDC scores (P , .05). One-month IKDC scores were related to the 1-month difference in knee-flexion ROM (P ¼ .04).Conclusions: The IKDC scores during the first 2 months were positively correlated with patients' perceptions of function on long-term IKDC scores. It also appears that improvements in lower extremity strength and flexion ROM deficits were positively associated with short-term IKDC scores. Higher BMI was negatively associated with patients' perceptions of function on short-term IKDC scores.Key Words: force output, knee, motion, rehabilitation, International Knee Documentation Committee Key PointsAfter anterior cruciate ligament reconstruction, patients' subjective International Knee Documentation Committee (IKDC) scores at both 1-and 2-month follow-ups had fair but significantly positive associations with the !12-month IKDC score. The ratio of surgical-to nonsurgical-limb measures of peak isometric knee-extension force at 1 and 2 months was positively associated with 1-and 2-month IKDC scores. The difference in flexion range of motion between the surgical and nonsurgical limbs had a significant positive relationship with 1-month IKDC score. Body mass index had a significant negative association with both 1-and 2-month IKDC scores. No significant relationships were noted between demographic, intraoperative, or postoperative variables during the first 2 months and IKDC scores at !12 months after anterior cruciate ligament reconstruction.

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Section: Discussionmentioning

confidence: 99%

What Can the First 2 Months Tell Us About Outcomes After Anterior Cruciate Ligament Reconstruction?

Christensen

Goldfine²,

Barker

et al. 2015

Journal of Athletic Training

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“…Detailed post-operative ACL reconstruction rehabilitation protocols have previously been published elsewhere [5][6][7][8]. Specific details regarding exercises and timing is beyond the scope of this paper, and it is recommended to consult these references for additional content.…”

Section: Rehabilitation Protocolsmentioning

confidence: 99%

Prevention and Management of Post-operative Complications Following ACL Reconstruction

Eckenrode

Carey

Sennett

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of Review The goal of this paper is to review the current management and prevention of post-operative complications after anterior cruciate ligament (ACL) reconstruction. Trends in rehabilitation techniques will be presented, in addition to suggestions for interventions and expected milestones in ACL reconstruction recovery. Recent Findings ACL reconstruction protocols have evolved to more of a criterion-based progression rather than a tissuehealing time frame. Given the evolution of ACL surgical reconstruction techniques and rehabilitation protocols, the risk of post-operative complications can arise both early and late in the recovery process. This paper will discuss the role of preventative measures as it applies to the post-operative patient with ACL reconstruction. Summary Short-term complications following ACL reconstruction include infection and deficits to knee motion and strength, whereas long-term complications include secondary ACL injury to either the involved or contralateral knee and lack of ability to return to high-level sports following this procedure. Future research should continue to address the multifactorial causes of secondary ACL injury and limited ability of patients to return to high level activities.

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“…What is the best timing for surgery postinjury? 6,22 What is the best graft and surgical approach for reconstruction? 8,14,21 What is the optimal selection and timing of exercises postsurgery?…”

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confidence: 99%

“…8,14,21 What is the optimal selection and timing of exercises postsurgery? 22 What is the optimal timing and criteria for return to sport (much more on this topic in JOSPT next month)? 7,15 These questions, to list just a few, are all important issues that remain a source of discussion and debate today.…”

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confidence: 99%