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

Abstract

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.

Comparing the Effectiveness of Blood Flow Restriction and Traditional Heavy Load Resistance Training in the Post-Surgery Rehabilitation of Anterior Cruciate Ligament Reconstruction Patients: A UK National Health Service Randomised Controlled Trial

“…Knee flexion (FE) was measured with patients bending their knee and slide their heel as far as possible toward their buttocks [58]. Side-to-side difference scores were calculated: difference (°) = (non-injured -injured) [7]. The ICC, SEM and MDC were 0.99, 0.01° and 0.03°, respectively.…”

“…Knee extensor (KE) and flexor (KF) muscle weakness is substantial during the first 12 weeks [3] following surgery, impairing lower limb function [4] and quality of life [5]. Muscle weakness can persist for years after ACLR surgery [6] and is associated with chronic reductions in function [7,8], a high re-injury risk [9] and joint degeneration [10]. Therefore, targeting muscle weakness early in the rehabilitation process is imperative [11].…”

Clinical Outcome Measures and Return-to-Sport Timing in Adolescent Athletes After Anterior Cruciate Ligament Reconstruction

“…Logerstedt et al 19 found that lower IKDC scores suggested poor isometric quadriceps strength during functional testing for clearance to return to activity. Christensen et al 18 noted an association between higher IKDC scores at 1 and 2 months after ACLR and better isometric extension limb symmetry. However, the average ages of the participants in these studies were 26.9 6 9.7 and 33.0 6 12.1 years, respectively.…”

Evaluation of Rehabilitation Parameters After Anterior Cruciate Ligament Reconstruction

“…year [1] with and an incidence of 81/100 000 people [2]. This stems from the fact that this surgery has become more reliable and efficient and the reeducation protocols are now more adapted [3].…”

“…In spite of this advancement in this area and the increasing number of surgeries, there are still some issues that researchers are trying to identify in order to optimize the quality of this operation and its outcomes [4]. Professionals are working on shortening the offfield period, identifying the needed number of therapeutic sessions, and establishing the most adapted post-operative reeducation protocol [5,6,2]. For all these reasons, it is crucial to assess the outcomes of the surgery as well as the post-operative reeducation.…”