Introducing our new 4 part blog series……….. ACL reconstruction and rehabilitation: Are we successful?

 Introducing our new 4 part blog series……….. ACL reconstruction and rehabilitation: Are we successful?

Ardern et al’s (2016) consensus statement on Return to Sport (RTS) following ACL reconstruction notes that the goal of the athlete (along with other stakeholders eg, coach, club, medical team) is a successful ‘safe and timely’ return to sport.

This highlights the importance of balancing three key components

-Minimising time away from play

-Minimising reinjury risk

-Maximising sporting performance upon return to play

Article review - Wellsandt et al (2017) - Limb Symmetry?

Article review - Wellsandt et al (2017) - Limb Symmetry?

Wellsandt et al (2017) Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury

Comparison between single leg hop and quad strength – in two different ways.

Who - Non professional cutting athletes, 14-55 yrs old(Excluded other significant injuries).

Limb Symmetry Index (LSI) = comparison between Left and Right during an assessment.

Estimated pre-injury capacity (EPIC) = measuring uninvolved limb pre-operatively then comparing to the involved side at 6 months post-op.

Article Review - Frobell et al (2010)

 

Frobell et al (2010) - Early ACL Reco + Rehabilitation compared to  Rehabilitation +Delayed ACL Reco if required (2 and 5 year follow up)

SUMMARY

  • 120 patients between -18-35 yrs  (Sub elite, recreational athletes) 
  • OUTCOME - Early ACLR and Rehab NOT superior to Rehab and Delayed ACLR (if required) at 2 and 5 years for KOOS (a questionnaire that compares pain, function in sport and recreation and knee related quality of life)  

Article Review - Kyritsis et al (2016)

Article Review - Kyritsis et al (2016)

Kyritsis et al (2016) Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

Summary

  • For every 10% loss of HS/Quads ratio = 10.6 x likelihood of graft rupture  

  • This ratio is increased if quadriceps strength is not fully regained to pre operative level

  • Meeting the 6 criteria - 116 athletes Discharged (73%) – (12/116 had a graft rupture) =  10%