The Effects of Rehabilitation Protocol on Functional Recovery After Anterior Cruciate Ligament Reconstruction

Dragičević-Cvjetković, Dragana; Jandrić, Slavica; Bijeljac, Sinisa; Palija, Stanislav; Manojlović, Slavko; Talić, Goran

doi:10.5455/medarh.2014.68.350-352

Cited by 19 publications

(18 citation statements)

References 14 publications

(12 reference statements)

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“…They both found no between-group differences in ROM, quadriceps and HS strength and hop tests at >1 year follow-up,56 57 but Grant and Mohtadi56 found a better self-reported knee function in the home-based group. The level C prospective cohort study of Dragicevic-Cvjetkovic et al 58 found a better self-reported knee function and greater improvement in thigh muscle circumference in a rehabilitation group (20 weeks) compared to a group with no rehabilitation at all at a 1 year follow-up.…”

Section: Resultsmentioning

confidence: 99%

Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

Melick

Cingel

Brooijmans³

et al. 2016

Br J Sports Med

582

572

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AimThe Royal Dutch Society for Physical Therapy (KNGF) instructed a multidisciplinary group of Dutch anterior cruciate ligament (ACL) experts to develop an evidence statement for rehabilitation after ACL reconstruction.DesignClinical practice guideline underpinned by systematic review and expert consensus.Data sourcesA multidisciplinary working group and steering group systematically reviewed the literature and wrote the guideline. MEDLINE and the Cochrane Library were searched for meta-analyses, systematic reviews, randomised controlled trials and prospective cohort studies published between January 1990 and June 2015.Eligibility criteria for selecting studiesIncluded literature must have addressed 1 of 9 predetermined clinical topics: (1) preoperative predictors for postoperative outcome, (2) effectiveness of physical therapy, (3) open and closed kinetic chain quadriceps exercises, (4) strength and neuromuscular training, (5) electrostimulation and electromyographic feedback, (6) cryotherapy, (7) measurements of functional performance, (8) return to play and (9) risk for reinjury.SummaryNinety studies were included as the basis for the evidence statement. Rehabilitation after ACL injury should include a prehabilitation phase and 3 criterion-based postoperative phases: (1) impairment-based, (2) sport-specific training and (3) return to play. A battery of strength and hop tests, quality of movement and psychological tests should be used to guide progression from one rehabilitation stage to the next. Postoperative rehabilitation should continue for 9–12 months. To assess readiness to return to play and the risk for reinjury, a test battery, including strength tests, hop tests and measurement of movement quality, should be used.

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Section: Resultsmentioning

confidence: 99%

Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

Melick

Cingel

Brooijmans³

et al. 2016

Br J Sports Med

582

572

View full text Add to dashboard Cite

show abstract

“…Massages allowed lymphatic drainage and decreased edema. Finally, the Lysholm-Tegner, IKDC, and KOOS questionnaires showed an increase in scores between preoperative evaluation and evaluation 6 months after surgery in both rehabilitation groups ( 41 ). Thus, patients judged the functionality of their knee to be better 6 months after surgery than before surgery.…”

Section: Discussionmentioning

confidence: 97%

Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes

Peultier-Celli

Mainard

Wein³

et al. 2017

Front. Surg.

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BackgroundInstability of the knee, related to anterior cruciate ligament injury, is treated by surgical reconstruction. During recovery, a loss of proprioceptive input can have a significant impact. Few studies have evaluated the benefits of rehabilitation of the knee in aquatic environment on functional outcomes.ObjectiveThis study aimed to compare an innovative rehabilitation protocol combining reduced conventional rehabilitation with aquatic rehabilitation, with a conventional rehabilitation, according to the National French Health Authority, in terms of kinetics, development of proprioceptive skills, and functional improvement of the knee.Methods67 patients, who were amateur or professional athletes, were randomized into two groups: 35 patients followed the conventional rehabilitation protocol (Gr1) and 32 patients followed the innovative rehabilitation protocol (Gr2). Patients were evaluated before surgery, and at 2 weeks, 1, 2, and 6 months after surgery using posturography, and evaluation of muscular strength, walking performance and proprioception. This study is multicenter, prospective, randomized, and controlled with a group of patients following conventional rehabilitation (level of evidence I).ResultsFor the same quality of postural control, Gr2 relied more on somesthesia than Gr1 at 6 months. The affected side had an impact on postural control and in particular on the preoperative lateralization, at 2 weeks and at 1 month. Lateralization depended on the affected knee, with less important lateralization in Gr2 preoperatively and at 1 month. The quadriceps muscular strength was higher in Gr2 than in Gr1 at 2 and 6 months and muscle strength of the external hamstring was greater in Gr2 than in Gr1 at 6 months. The isokinetic test showed a greater quadriceps muscular strength in Gr2. Gr2 showed a greater walking distance than Gr1 at one month. Gr2 showed an improvement in the proprioceptive capacities of the operated limb in flexion for the first 2 months.ConclusionThe effectiveness of the innovative rehabilitation program permits faster recovery, allowing for an earlier return to social, sporting, and professional activities. Faster retrieval of knee function following aquatic rehabilitation would prevent both short-term risk of lesions of the contralateral limb due to overcompensation and long-term risk of surgery due to osteoarthritis.Registration of clinical trialsNCT02225613.

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“…Cvjetkovic, et al [ 46 ], in their prospective study of 70 males, examined the effect of a rehabilitation program on thigh muscle circumference and modified Tegner Lysholm score. Patients were divided into two groups each of 35 patients.…”

Section: Reviewmentioning

confidence: 99%

Current Trends in Anterior Cruciate Ligament Reconstruction: A Review

Vaishya

Ingole

et al. 2015

Cureus

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Anterior cruciate ligament reconstruction (ACLR) is an accepted and established surgical technique for anterior cruciate ligament (ACL) injuries and is now being practiced across the globe in increasing numbers. Although most patients get good to excellent results in the short-term after ACLR, its consequences in the long-term in prevention or acceleration of knee osteoarthritis (OA) are not yet well-defined. Still, there are many debatable issues related to ACLR, such as the appropriate timing of surgery, graft selection, fixation methods of the graft, operative techniques, rehabilitation after surgery, and healing augmentation techniques. Most surgeons prefer not to wait long after an ACL injury to do an ACLR, as delayed reconstruction is associated with secondary damages to the intra- and periarticular structures of the knee. Autografts are the preferred choice of graft in primary ACLR, and hamstring tendons are the most popular amongst surgeons. Single bundle ACLR is being practiced by the majority, but double bundle ACLR is getting popular due to its theoretical advantage of providing more anatomical reconstruction. A preferred construct is the interference fixation (Bio-screw) at the tibial site and the suspensory method of fixation at the femoral site. In a single bundle hamstring graft, a transportal approach for creating a femoral tunnel has recently become more popular than the trans-tibial technique. Various healing augmentation techniques, including the platelet rich plasma (PRP), have been tried after ACLR, but there is still no conclusive proof of their efficacy. Accelerated rehabilitation is seemingly more accepted immediately after ACLR.

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The Effects of Rehabilitation Protocol on Functional Recovery After Anterior Cruciate Ligament Reconstruction

Cited by 19 publications

References 14 publications

Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus

Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes

Current Trends in Anterior Cruciate Ligament Reconstruction: A Review

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