The Biology of Bone and Ligament Healing

Cottrell, Jessica; Turner, Jessica Cardenas; Arinzeh, Treena Livingston; O’Connor, J. P.

doi:10.1016/j.fcl.2016.07.017

Cited by 64 publications

(52 citation statements)

References 174 publications

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“…This places additional load on particular joints such as the knee and ankle, increasing an athlete's risk of sustaining ligament injuries . The substantial nature of these particular types may be as a result of the healing process involved with ligaments in comparison to other anatomical structures, as well as recommendations regarding a secondary, delayed assessment of ligament injuries . Field hockey athletes perform a high number of accelerations and decelerations during competition, placing significant load through muscle groups such as the hamstrings and muscles of the hip .…”

Section: Discussionmentioning

confidence: 99%

Transient injuries are a problem in field hockey: A prospective one‐season cohort study

et al. 2019

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Injury definitions encompass all physical complaints, medical attention, and time loss. Expressing injury burden in terms of short‐ and long‐term impact on athlete performance may be meaningful for coaches in terms of preparation. Therefore, our aim was to describe transient (symptoms <7 days) and substantial (symptoms ≥7 days) injuries suffered in field hockey throughout the Irish Hockey League (IHL). Following ethical approval, participants were assigned unique accounts to record injuries through a monitoring software. An all physical complaints definition was adopted. Team physiotherapists were contacted weekly to further capture and corroborate details on injuries. Transient and substantial injury classifications were applied. A total of 173 injuries in 14 690 exposure hours (11.8/1000 h) occurred. Incidence of medical attention (n = 119) and time‐loss (n = 70) injuries was 8.1/1000 h and 4.8/1000 h. Teams suffered transient injuries every 2.3 weeks (median = 2, IQR = 4) at a rate of 6.3/1000 h and substantial injuries every 2.5 weeks (median = 1.5, IQR = 3.25) at a rate of 5.5/1000 h. The lower back and knee were common transient injuries (7.5%), with the hamstring a common substantial injury (11.6%). Although many field hockey injuries are substantial, transient injuries are equally as frequent. These additional means of classifying injuries inform teams of the injuries that will cause disruption within their squad.

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Section: Discussionmentioning

confidence: 99%

Transient injuries are a problem in field hockey: A prospective one‐season cohort study

et al. 2019

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“…5 However, the repair and remodeling process of an injured tissue may be much slower than the patient's typical functional progression which is largely driven by the patient's desire to return to activity and competition. 20,21 In the largest acute ankle sprain study to date, Brison et al investigated standardized physical therapy procedures not utilizing specific ligament protection and healing measures and found no difference between physical therapy and usual medical care. 22 These findings suggest that either the injury has an unfavorable prognosis regardless of management or the essential aspects of treatment that would improve outcomes were missing in both physical therapy and usual medical care.…”

Section: Background and Purposementioning

confidence: 99%

“…There is a predictable healing pathway after ligamentous injury that includes an acute inflammatory phase, proliferative phase, and a remodeling phase that increases tensile properties. 21 Although evidence from ankle ligament specific healing studies is very limited, acute ankle sprains should be managed in a manner consistent with the general knowledge of proper management of ligamentous injury. For example, controlled ROM through bracing is a foundational strategy for managing a tear to the medial collateral ligament of the knee.…”

Section: Background and Purposementioning

confidence: 99%

Management of Acute Grade Ii Lateral Ankle Sprains With an Emphasis on Ligament Protection: A Descriptive Case Series

Wells

Allen

Deyle

et al. 2019

Intl J Sports Phys Ther

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Background and Purpose: Lateral ankle sprain the most common injury in physically active populations. Individuals who sustain an acute lateral ankle sprain may not receive timely formal rehabilitation and are at an increased risk to have subsequent sprains which can lead to chronic pain and instability. Attention to essential factors for ligament protection and healing while preserving ankle movement, may result in a more stable yet mobile ankle offering improved outcomes. The purpose of this case series was to describe the methods and observe the outcomes associated with a comprehensive strategy for managing acute first episode grade II lateral ankle sprains. Study design: Prospective case series. Case Descriptions and Interventions: Ten patients (mean age 26.7 years, range 16-51 years, mean 2.3 days from injury) with acute grade II lateral ankle sprain were treated with an approach to protect the injured ligament, prevent impairments to movement, restore strength and proprioception, and progress to full function. Patient outcomes were assessed at four, eight and 12 weeks. Follow-up interviews at six and 12 months assessed injury recurrence. Outcomes: Patients were treated for an average of eight sessions over a mean of seven weeks. Rapid change in selfreported function, ankle ROM, and pain were observed in the first four weeks of care. Clinically meaningful improvements in function and ankle ROM were also noted at eight weeks and maintained at 12-week follow-ups. All patients returned to desired physical activity with only a single re-sprain event within one year after injury. Conclusion: The results of this prospective case series suggest that a treatment approach designed to protect the injured ligament, maintain and restore normal ankle motion, and provide a tailored functional pathway to return to run and sport demonstrated resolution of symptoms and improvement in reported functional outcomes in a group of patients following grade II acute primary ankle sprain.

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“…From a biomechanical point of view, the joint should be stabilized throughout the recovery phase with a gradual increase in the ankle joint loading and range of motion (RoM) to ensure enough mechanical stimulation for tissue healing while avoiding excessive loading [20]. According to an in vitro cadaveric study, the ankle joint can be plantar-flexed up to 16 • and dorsi-flexed up to 18 • to significantly induce stress in the ligaments under unloaded condition [21], with reports of a sometimes significant alteration of stretch-induced stress in the ligaments upon further axial loading [22].…”

Section: Introductionmentioning

confidence: 99%

Restrictions in the Ankle Sagittal- and Frontal-Plane Range of Movement during Simulated Walking with Different Types of Orthoses

Thiele¹,

Schuhmacher²,

Schwaller³

et al. 2018

JFMK

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Different types of orthoses are available to clinicians for non-surgical treatment of acute ankle sprains. The goal of this study was to scientifically compare the movement restrictions in the sagittal and frontal plane during simulated walking between one adaptable semi-rigid brace (OrthoTri-Phase TM), four non-adaptable semi-rigid braces (OrthoStandard TM , MalleoLoc TM , MalleoSprint TM , VACOankle TM), and one rigid cast. Predefined time sequences of rotational moments and axial loading during gait were applied via an ankle joint simulator, with the pneumatic pressure inside the orthoses kept constant to ensure the same condition for different trials and orthoses. The peak ranges of motion (RoMs) in the frontal and sagittal plane during gait were analyzed for statistically significant differences using single-factorial ANOVA with post-hoc Bonferroni analysis. Significant differences in peak plantar-/dorsiflexion and in-/eversion RoM during gait were found between different types of orthoses. In the sagittal plane, the rigid cast most significantly restricted overall RoM followed by the Ortho Tri-Phase TM in Phase 1 and the Ortho Standard TM. The peak restriction in-/eversion RoM of the VACOankle TM came closest to the rigid cast, with a shift towards inversion. The VACOankle TM allowed for significantly larger dorsiflexion movement compared to all other orthoses. The present results may help clinicians in the decision-making process of finding the optimal orthosis for individual patients.

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The Biology of Bone and Ligament Healing

Cited by 64 publications

References 174 publications

Transient injuries are a problem in field hockey: A prospective one‐season cohort study

Transient injuries are a problem in field hockey: A prospective one‐season cohort study

Management of Acute Grade Ii Lateral Ankle Sprains With an Emphasis on Ligament Protection: A Descriptive Case Series

Restrictions in the Ankle Sagittal- and Frontal-Plane Range of Movement during Simulated Walking with Different Types of Orthoses

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