ACL reconstruction

Only 1 in 5 patients achieve limb symmetry at 6 months post ACL reconstruction

Only 1 in 5 patients achieve limb symmetry at 6 months post ACL reconstruction

In early 2019 Cristiani et al published an article showing < 20% of patients met rehabilitation goals of having > 90% limb symmetry in strength (isokinetic quads and hamstrings at 90deg/sec) and single hop for distance tests at 6 months post-op.

This study had a very large sample size (4093 patients), comprising 45.7% females, with a mean age of 28 years (+/-10 years). 86.5% of participants completed the full test battery at 6 months post-op.

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 - 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%