The Relationship Between Passive Joint Laxity and Functional Outcome After Anterior Cruciate Ligament Injury

Snyder‐Mackler, Lynn; Fitzgerald, G. Kelley; Bartolozzi, Arthur R.; Ciccotti, Michael G.

doi:10.1177/036354659702500209

Cited by 235 publications

(179 citation statements)

References 22 publications

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“…12 This injury frequently results in knee joint instability, muscle weakness, and neuromuscular control deficits of the involved limb. 6,40,44 In an attempt to restore these deficits and safely return patients to preinjury activities, reconstruction of the ACL is commonly performed. 10,17 Current rehabilitation programs following ACL reconstruction (ACLR) emphasize early weight-bearing activities, restoration of knee range of motion, and muscle strength.…”

mentioning

confidence: 99%

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Xergia

Pappas²,

Zampeli³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

124

131

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Study Design Within-subject and between-subject cross-sectional study. Objectives To investigate symmetry in hop-test performance, strength, and lower extremity kinematics 6 to 9 months following anterior cruciate ligament reconstruction (ACLR). Background Despite the extensive body of literature involving persons following ACLR, no study has comprehensively evaluated measures of strength, lower extremity kinematics, and functional performance of functional hop tests in this population. Methods The subjects were 22 men (mean ± SD age, 28.8 ± 11.2 years) who had ACLR using a bone-patellar tendon-bone autograft 6 to 9 (7.01 ± 0.93) months previously and 22 healthy male controls (age, 24.8 ± 9.1 years). Participants completed a self-report questionnaire and underwent isokinetic strength testing and functional and kinematic assessment of the single-, triple-, and crossover-hop tests. Two-way analyses of variance were used to test for differences between the ACLR group and the control group, and between the 2 lower extremities of the ACLR group. Results Compared to the control group, the ACLR group had greater isokinetic knee extension torque deficits at all speeds (P≤.001) and greater performance asymmetry for all 3 hop tests (P<.001). Compared to the noninvolved lower extremity, the involved lower extremity of the ACLR group exhibited less ankle dorsiflexion and knee flexion in the phases of propulsion (P≤.014) and landing (P≤.032). When compared to the control group, the involved lower extremity exhibited less ankle dorsiflexion in the propulsion phase (P<.001) but higher hip flexion in the landing phase (P = .014). Conclusion Six to 9 months following ACLR, patients continue to demonstrate functional hop and isokinetic knee extension deficits, as well as kinematic differences, during the propulsion and landing phases of the hop tests. J Orthop Sports Phys Ther 2013;43(3):154–162. Epub 14 January 2013. doi:10.2519/jospt.2013.3967

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mentioning

confidence: 99%

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Xergia

Pappas²,

Zampeli³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

124

131

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“…SnyderMackler et al 34 performed a study of twenty patients with an anterior cruciate-deficient knee, ten of whom were classified as compensators (individuals who returned to all sports activities without operative treatment) and ten of whom were classified as noncompensators (patients who ultimately underwent reconstruction of the anterior cruciate ligament). Objective knee laxity, as evaluated with a KT-2000 arthrometer, was actually greater in the compensators.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome at a Minimum of Five Years After Reconstruction of the Anterior Cruciate Ligament

Spindler¹,

WARREN²,

CALLISON³

et al. 2005

The Journal of Bone and Joint Surgery-American Volume

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“…Because many patients who undergo these procedures are young and active, surgical stabilization of the knee is an attractive option [1,18,25,41]. However, which technique and graft to use to best restore knee stability are matters of debate.…”

Section: Introductionmentioning

confidence: 99%

Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

Arno

Bell

Alaia

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Considerable debate remains over which anterior cruciate ligament (ACL) reconstruction technique can best restore knee stability. Traditionally, femoral tunnel drilling has been done through a previously drilled tibial tunnel; however, potential nonanatomic tunnel placement can produce a vertical graft, which although it would restore sagittal stability, it would not control rotational stability. To address this, some suggest that the femoral tunnel be created independently of the tibial tunnel through the use of an anteromedial (AM) portal, but whether this results in a more anatomic footprint or in stability comparable to that of the intact contralateral knee still remains controversial. Questions/purposes (1) Does the AM technique achieve footprints closer to anatomic than the transtibial (TT) technique? (2) Does the AM technique result in stability equivalent to that of the intact contralateral knee? (3) Are there differences in patient-reported outcomes between the two techniques? Methods Twenty male patients who underwent a bonepatellar tendon-bone autograft were recruited for this study, 10 in the TT group and 10 in the AM group. Patients in each group were randomly selected from four surgeons at our institution with both groups demonstrating similar demographics. The type of procedure chosen for each patient was based on the preferred technique of the surgeon. Some surgeons exclusively used the TT technique, whereas other surgeons specifically used the AM technique. Surgeons had no input on which patients were chosen to participate in this study. Mean postoperative time was 13 ± 2.8 and 15 ± 3.2 months for the TT and AM groups, respectively. Patients were identified retrospectively as having either the TT or AM Technique from our institutional database. At followup, clinical outcome scores were gathered as well as the footprint placement and knee stability assessed. To assess the footprint placement and knee stability, three-dimensional surface models of the femur, tibia, and ACL were created from MRI scans. The femoral and tibial footprints of the ACL reconstruction as compared with the intact contralateral ACL were determined. In addition, the AP displacement and rotational displacement of the femur were determined. Lastly, as a secondary measurement of stability, KT-1000 measurements were obtained at the followup visit. An a priori sample size calculation indicated that with 2n = 20 patients, we could detect a difference of 1 mm with 80% power at p \ 0.05. A Welch two-sample t-test (p \ 0.05) was performed to determine differences in the footprint measurements, AP displacement, rotational displacement, and KT-1000 measurements between the TT and AM groups. We further used the confidence interval approach with 90% confidence intervals on the pairwise mean group differences using a Games-Howell post hoc test to assess equivalence between the TT and AM groups for the previously mentioned measures. Results The AM and TT techniques were the same in terms of footprint except in the distal...

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The Relationship Between Passive Joint Laxity and Functional Outcome After Anterior Cruciate Ligament Injury

Cited by 235 publications

References 22 publications

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Asymmetries in Functional Hop Tests, Lower Extremity Kinematics, and Isokinetic Strength Persist 6 to 9 Months Following Anterior Cruciate Ligament Reconstruction

Clinical Outcome at a Minimum of Five Years After Reconstruction of the Anterior Cruciate Ligament

Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

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