Treatment Decision after Anterior Cruciate Ligament Injury, and Evaluation of Measurement Properties of a Patient Reported Outcome Measure

Grevnerts, Hanna Tigerstrand

doi:10.3384/diss.diva-160918

Cited by 3 publications

(2 citation statements)

References 90 publications

(184 reference statements)

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“…The reasons for deciding on ACLR after 3 months was both knee joint instability and high activity demands. 38 Self-reported function and activity participation may have been influenced by the surgery. Most participants with ACL injury also reported that they were completing rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Short-term recovery of physical activity and knee function after an acute knee injury

Fomin

Gauffin

Kvist

2020

BMJ Open Sport Exerc Med

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ObjectivesTo describe self-reported knee function, participation in physical activity and the number of knee surgeries at 3 and 6 months following acute knee injury.MethodsProspective cohort study. Participants, aged 15–40 years with an acute knee injury sustained no more than 6 weeks prior to inclusion, were recruited. There were 279 participants with ACL injury and 101 participants with other acute knee injuries included. Follow-up questionnaires were sent at 3 and 6 months after injury. Demographic information, activity participation, International Knee Documentation Committee subjective knee form (IKDC-SKF) and the Single Assessment Numeric Evaluation (SANE) score were collected. Additional knee injuries were obtained from self-report and medical charts.ResultsThe IKDC-SKF, SANE and physical activity participation were reduced at 3-month and 6-month follow-up. The number of participants who achieved health-promoting physical activity levels was reduced by 50% at 6-month follow-up compared with before injury. Seventeen per cent of participants with ACL injury and 41% of participants with other acute knee injuries had returned to their preinjury physical activity at 6 months. Participants with ACL injury reported worse knee function, lower physical activity participation and had more surgeries (128 surgeries, including 109 ACL-reconstructions) compared with participants with other acute knee injuries (six surgeries).ConclusionAcute knee injuries, including ACL injuries, affected self-reported knee function and physical activity participation for at least 6 months after index injury. More research is needed to understand how best to help people with acute knee injuries return to physical activity and achieve satisfactory knee function.

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Section: Discussionmentioning

confidence: 99%

Short-term recovery of physical activity and knee function after an acute knee injury

Fomin

Gauffin

Kvist

2020

BMJ Open Sport Exerc Med

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“…The treatment choice is based on the patient's symptoms, type of injury to the ligament, examination, the growth remaining in his or her growth plates, and activity goals [5][6].…”

Section: Treatmentmentioning

confidence: 99%

Conservative vs Surgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review

Papaleontiou,

Poupard,

Mahajan

et al. 2024

Cureus

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Anterior cruciate ligament (ACL) injury is very common, especially in young athletic individuals who injure themselves during sports involving pivoting actions.Management options include conservative management, which involves progressive physical therapy, educating the patient on how to prevent instability, and the use of a hinged knee brace. Surgical management involves reconstruction of the torn ligament using an autograft or an allograft and ACL repair where the torn ligament is affixed back to the tibia or femur. The choice of management depends on the severity of the injury, other injuries in associated structures, the level of fitness, and the athletic goals of the patient.Many studies exist on the management choice of ACL injury, but no clear consensus prevails. This study will examine the effectiveness of conservative versus surgical management. A literature review will be performed to identify appropriate papers which compare and evaluate the two approaches.A literature search for randomized controlled trials (RCTs) and cohort studies comparing the conservative to surgical management of ACL injury was conducted on PubMed, Scopus, and Web of Science. Patient eligibility criteria included individuals older than 15 with an isolated, recent ACL injury diagnosis via an appropriate clinical test, MRI, or arthroscopy. Studies were eligible if they were using appropriate surgical or conservative methods, as mentioned previously, and measuring results via appropriate scores, tools, and methods that will be presented below. The follow-up timeline would be from presentation time until at least two years.Five papers were found to be eligible. Overall, these papers included 462 patients. Two studies measuring overall knee symptoms, function, and sports activities using the International Knee Documentation Committee Subjective Knee Form (IKDC) score found that the operated group had a significantly higher score. The other two studies measured overall knee function and health using the Tegner & Lysholm and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores. In both papers, no significant difference was found between the two groups.Regarding Tegner's activity score, only one paper had significant findings. A significantly longer period to return to sports activities was observed in the operative group. Stability was significantly higher in all papers in the operated group. Osteoarthritis was measured using different tools in each paper. Only one paper found a significantly higher risk in the operated group. Only one paper indicated significantly more complications in the operated group regarding side effects.Overall, very few differences were observed between the two treatment groups. The most significant differences observed were the higher stability and the longer recovery period in patients undergoing surgery. Large RCTs following patients for enough time are needed to prove if surgical treatment offers significant benefits over conservative treatment.

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Fear of Reinjury Following Surgical and Nonsurgical Management of Anterior Cruciate Ligament Injury: An Exploratory Analysis of the NACOX Multicenter Longitudinal Cohort Study

Kvist

Filbay

2021

Physical Therapy

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Objectives The purpose of this study was to compare fear and certainty of reinjury between follow-up time points and treatment groups (no anterior cruciate ligament [ACL] reconstruction [no ACLR], pre-ACLR, post-ACLR) and to identify prognostic factors for fear of reinjury at 3 and 12 months following injury or ACLR. Methods An exploratory analysis of the NACOX multicenter longitudinal cohort study was conducted. Patients (n = 275) with primary ACL injury and 15 to 40 years of age received usual care (initial physical therapist–supervised rehabilitation, before considering ACLR). Fear of reinjury (as measured with the Anterior Cruciate Ligament Quality of Life instrument [ACL-QOL] item 31 and the Anterior Cruciate Ligament Return to Sport After Injury instrument [ACL-RSI] item 9) and certainty of reinjury (as measured with the Knee Self-Efficacy Scale [K-SES] item D2) were evaluated at baseline and at 3-, 6-, and 12-months following ACL injury or ACLR. Comparisons were performed with linear mixed models. Linear regression assessed potential prognostic factors (age, sex, preinjury activity, baseline knee function, baseline general self-efficacy, and expected recovery time) for fear of reinjury (ACL-QOL item 31) at the 3- and 12-month follow-up assessments. Results Fear of reinjury was common regardless of ACL treatment. Fear of reinjury decreased between 3 and 6 months and 3 and 12 months (mean difference: ACL-QOL = 9 [95% CI = 2 to 15]; ACL-RSI = 21 [95% CI = 13 to 28]) after injury. This improvement was not observed in patients who later underwent ACLR, who reported worse fear of reinjury at 3 months (ACL-QOL = 10 [95% CI = 3 to 18]) and at 12 months (ACL-RSI = 22 [95% CI = 2 to 42]) postinjury compared with those who did not proceed to ACLR. Following ACLR, fear of reinjury decreased between the 3- and 12-month follow-up assessments (ACL-QOL = 10 [95% CI = 4 to 16]; ACL-RSI = 12 [95% CI = 5 to 19]). Greater baseline general self-efficacy was associated with reduced fear of reinjury at 12 months after injury (adjusted coefficient = 1.7 [95% CI = 0.0 to 3.5]). Female sex was related to more fear of reinjury 3 months after ACLR (−14.5 [95% CI = −25.9 to −3.1]), and better baseline knee function was related to reduced fear of reinjury 12 months after ACLR (0.3 [95% CI = 0.0 to 0.7]). Conclusions People who had ACLR reported worse fear of reinjury before surgery than those who did not proceed to ACLR. Different prognostic factors for fear of reinjury were identified in people treated with ACLR and those treated with rehabilitation alone. Impact Fear of reinjury is a concern following ACL injury. Clinicians should evaluate and address reinjury fears. These results may assist in identifying individuals at risk of fear of reinjury following surgical and nonsurgical management of ACL injury.

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Treatment Decision after Anterior Cruciate Ligament Injury, and Evaluation of Measurement Properties of a Patient Reported Outcome Measure

Cited by 3 publications

References 90 publications

Short-term recovery of physical activity and knee function after an acute knee injury

Short-term recovery of physical activity and knee function after an acute knee injury

Conservative vs Surgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review

Fear of Reinjury Following Surgical and Nonsurgical Management of Anterior Cruciate Ligament Injury: An Exploratory Analysis of the NACOX Multicenter Longitudinal Cohort Study

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