1
|
Wong CY(T, Mok KM, Yung SH(P. Secondary Anterior Cruciate Ligament Injury Prevention Training in Athletes: What Is the Missing Link? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4821. [PMID: 36981735 PMCID: PMC10049415 DOI: 10.3390/ijerph20064821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
After reconstruction, the return to full competition rate of athletes is low, while the re-injury rate remains high despite the completion of a rehabilitation programme. Primary ACL prevention programmes are well developed, yet few research papers focus on secondary ACL injury prevention. The aim of current review is to determine if current ACL secondary prevention training has a positive influence on the re-injury rate, the clinical or functional outcomes, or the risk of re-injury in athletes. Studies investigating secondary prevention of ACL were searched in PubMed and EBSCOhost, followed by a review of the references in the identified articles. The existing evidence suggests that neuromuscular training, eccentric strengthening, and plyometric exercises may have a potential impact on improving biomechanical, functional, and psychological outcomes in athletes; however, the studies on the prevention of second ACL injury in athletes is scarce and inconclusive. Future research is needed to investigate the effectiveness of secondary ACL prevention in reducing the re-injury rates. (PROSPERO Registration number: CRD42021291308).
Collapse
Affiliation(s)
- Choi-Yan (Tiffany) Wong
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (C.-Y.W.); (K.-M.M.)
| | - Kam-Ming Mok
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (C.-Y.W.); (K.-M.M.)
- Office of Student Affairs, Lingnan University, Hong Kong, China
- School of Interdisciplinary Studies, Lingnan University, Hong Kong, China
| | - Shu-Hang (Patrick) Yung
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (C.-Y.W.); (K.-M.M.)
| |
Collapse
|
2
|
Van Cant J, Pairot de Fontenay B, Douaihy C, Rambaud A. Characteristics of return to running programs following an anterior cruciate ligament reconstruction: A scoping review of 64 studies with clinical perspectives. Phys Ther Sport 2022; 57:61-70. [PMID: 35921783 DOI: 10.1016/j.ptsp.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To (1) describe return to running (RTR) programs used during rehabilitation after anterior cruciate ligament reconstruction (ACLR); and (2) provide clinical guidelines for RTR program after ACLR. DESIGN Scoping review. LITERATURE SEARCH We searched the MEDLINE (Pubmed), EMBASE, Web of Science and PEDro databases. STUDY SELECTION CRITERIA We included randomized controlled trial (RCT), cases series, meta-analyses, both scoping and systematic reviews including a rehabilitation program after ACLR with a specific RTR program. A "Running program checklist" (RPC) was elaborated based on the Template for Intervention Description and Replication (TIDieR), and on the Consensus on Exercise Reporting Template (CERT) checklist. DATA SYNTHESIS The percentage and number of studies specifying each of the running program checklist items in their RTR program were reported. Number of items reported in each study and specific analysis item-by-item were also proposed. RESULTS The "When (2)" item was the most frequently found (92.19%) and, conversely, the "Who (1)" item appeared only in four studies (6.2%). One-third of the studies presented only one item of the RPC, and 48 of the 64 articles discussed less than three items. Two studies described in detail their RTR program by reporting 8 and 9 items out of the 10, respectively. No study presented 10 of the PRC items. CONCLUSION There is a serious lack of information concerning RTR program following ACLR in the literature and further studies are needed to establish a program based on the best evidence.
Collapse
Affiliation(s)
- Joachim Van Cant
- Faculty of Motors Sciences, Université Libre de Bruxelles, Brussels, Belgium; SFMKS Lab, Pierrefitte-sur-Seine, France; The Running Clinic, Lac Beauport, Canada.
| | - Benoît Pairot de Fontenay
- SFMKS Lab, Pierrefitte-sur-Seine, France; Inter-university Laboratory of Human Movement Science (LIBM EA 7424), Univ Lyon - UJM, Saint Etienne, France; The Running Clinic, Lac Beauport, Canada
| | - Charbel Douaihy
- Faculty of Motors Sciences, Université Catholique de Louvain, Brussels, Belgium
| | - Alexandre Rambaud
- SFMKS Lab, Pierrefitte-sur-Seine, France; Univ Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, EA 7424, F-42023, Saint-Etienne, France; Department of Clinical and Exercise Physiology, Sports Medicine Unity, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
| |
Collapse
|
3
|
de Fontenay BP, van Cant J, Gokeler A, Roy JS. Reintroduction of running after ACL reconstruction with a hamstring graft: can we predict short-term success? J Athl Train 2021; 57:540-546. [PMID: 34623431 DOI: 10.4085/1062-6050-0407.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Return to running (RTR) after anterior cruciate ligament reconstruction (ACL-R) is a crucial milestone. However, there is uncertainty on how and when to start a running program. OBJECTIVE To explore the feasibility of a structured program to reintroduce running after ACL-R and to evaluate the predictive value of potential predictors of short-term success. DESIGN Longitudinal cohort study. SETTING Local Research Center / participant's home. PATIENTS Thirty-five participants were recruited after ACL-R. INTERVENTION Program with a progression algorithm to reintroduce running (10 running sessions in 14 days). MAIN OUTCOME MEASURES The criterion for short-term success was no exacerbation of symptoms. Potential predictors included: (i) the International Knee Document Committee (IKDC) subjective knee form; (ii) ACL Return to Sport after Injury questionnaire; (iii) quadriceps and hamstring strength; (iv) Step-Down Endurance test; and (v) the modified Star Excursion Balance test. Descriptive statistics were performed to study the feasibility of the RTR program and Poisson regression analysis was used to evaluate predictors of success. RESULTS Of the 34 participants included, 33 completed the RTR program. Sixteen participants experienced some temporary exacerbation of symptoms, but only one had to stop the RTR program. Initial IKDC score was the only significant predictor of a successful RTR with an Area under the ROC curve of 80.4%. An ICKD cut-off of 63.7/100 differentiated responders and non-responders with the highest sensitivity and specificity (77.8% and 75.0%, respectively). There was a 3-fold greater chance of success with an IKDC score above this threshold. CONCLUSIONS Our results confirm the feasibility of our RTR program and progression algorithm after ACL-R. Clinicians should use an IKDC score of >64 as a criterion to reintroduce running after ACL-R to increase the likelihood of short-term success.
Collapse
Affiliation(s)
- Benoit Pairot de Fontenay
- 1 University of Lyon - University Claude Bernard Lyon 1, EA 7424 - Inter-university Laboratory of Human Movement Science
| | - Joachim van Cant
- 2 Faculté des Sciences de la Motricité, Université Libre de Bruxelles, Brussels, Belgium
| | - Alli Gokeler
- 3 Exercise Science & Neuroscience Unit, Department Exercise and Health, Faculty of Science, Paderborn University, Paderborn.,4 Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg.,5 Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jean-Sebastien Roy
- 6 Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8.,7 Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada G1R 1P5
| |
Collapse
|
4
|
Dauty M, Edouard P, Menu P, Mesland O, Fouasson-Chailloux A. Isokinetic quadriceps symmetry helps in the decision to return to running after anterior cruciate ligament reconstruction. Ann Phys Rehabil Med 2021; 65:101543. [PMID: 34091057 DOI: 10.1016/j.rehab.2021.101543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/05/2021] [Accepted: 04/14/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Marc Dauty
- CHU Nantes, Physical Medicine and Rehabilitation Center, University Hospital of Nantes, France; CHU Nantes, Service de Médecine du Sport, University Hospital of Nantes, France; INSERM UMR U1229/RMeS, Regenerative Medicine and Skeleton - Nantes University, France
| | - Pascal Edouard
- Inter-university Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean-Monnet, 42023 Saint Étienne, France; Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Étienne, France
| | - Pierre Menu
- CHU Nantes, Physical Medicine and Rehabilitation Center, University Hospital of Nantes, France; CHU Nantes, Service de Médecine du Sport, University Hospital of Nantes, France; INSERM UMR U1229/RMeS, Regenerative Medicine and Skeleton - Nantes University, France
| | - Olivier Mesland
- CHU Nantes, Physical Medicine and Rehabilitation Center, University Hospital of Nantes, France; INSERM UMR U1229/RMeS, Regenerative Medicine and Skeleton - Nantes University, France
| | - Alban Fouasson-Chailloux
- CHU Nantes, Physical Medicine and Rehabilitation Center, University Hospital of Nantes, France; CHU Nantes, Service de Médecine du Sport, University Hospital of Nantes, France; INSERM UMR U1229/RMeS, Regenerative Medicine and Skeleton - Nantes University, France.
| |
Collapse
|
5
|
Vascellari A, Grassi A, Combi A, Tomaello L, Canata GL, Zaffagnini S. Web-based survey results: surgeon practice patterns in Italy regarding anterior cruciate ligament reconstruction and rehabilitation. Knee Surg Sports Traumatol Arthrosc 2017; 25:2520-2527. [PMID: 26831862 DOI: 10.1007/s00167-016-4007-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/18/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to report Italian orthopaedic surgeons' management of choice for ACL reconstruction and rehabilitation, and to compare surgical applications and rehabilitation approaches of Italian surgeons to the current approaches of "ACL Study Group". A secondary purpose was to compare the preferences of subgroup based on graft choice, surgical techniques and experience. METHODS A web-based survey was developed to investigate the attitudes of members of a national association specialized in sports traumatology and knee surgery (SIGASCOT) regarding surgical techniques, routine post-operative applications, rehabilitation approaches and starting time of specific activities and exercises following ACL reconstruction. RESULTS The response rate was 17 % (131 questionnaires). The most popular graft type was hamstring tendon (81 % in male patients, and 91 % in female patients). The rate of continuous passive motion use was 55 %. Half surgeons routinely used a brace (49 %), usually a hinged brace. In total, 33.0 % of surgeons allowed patients to load the operated knee as much as tolerated within the first 2 weeks. Fifty-nine per cent of surgeons did not limit full flexion within the first 2 weeks. Most surgeons advise to wait until 4 months or more (97 %) for return to sports not requiring contact, and 6 months or more for full-contact sport (86 %). CONCLUSIONS This survey demonstrates clear trends in the practice of ACL reconstruction and rehabilitation in Italy. The data obtained from the SIGASCOT members revealed a more conservative approach when compared to the current approaches of "ACL Study Group". LEVEL OF EVIDENCE Cross-sectional survey, Level III.
Collapse
Affiliation(s)
- Alberto Vascellari
- Orthopaedic and Traumatology Department, Oderzo Hospital, Oderzo, Treviso, Italy.
| | - Alberto Grassi
- 2nd Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Alberto Combi
- Orthopaedic and Traumatology Department, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | | | | | - Stefano Zaffagnini
- 2nd Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | | |
Collapse
|
6
|
Kruse L, Gray B, Wright R. Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am 2012; 94:1737-48. [PMID: 23032584 PMCID: PMC3448301 DOI: 10.2106/jbjs.k.01246] [Citation(s) in RCA: 189] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Rigorous rehabilitation after anterior cruciate ligament (ACL) reconstruction is necessary for a successful surgical outcome. A large number of clinical trials continue to assess aspects of this rehabilitation process. Prior systematic reviews evaluated fifty-four Level-I and II clinical trials published through 2005. METHODS Eighty-five articles from 2006 to 2010 were identified utilizing multiple search engines. Twenty-nine Level-I or II studies met inclusion criteria and were evaluated with use of the CONSORT (Consolidated Standards of Reporting Trials) criteria. Topics included in this review are postoperative bracing, accelerated strengthening, home-based rehabilitation, proprioception and neuromuscular training, and six miscellaneous topics investigated in single trials. RESULTS Bracing following ACL reconstruction remains neither necessary nor beneficial and adds to the cost of the procedure. Early return to sports needs further research. Home-based rehabilitation can be successful. Although neuromuscular interventions are not likely to be harmful to patients, they are also not likely to yield large improvements in outcomes or help patients return to sports faster. Thus, they should not be performed to the exclusion of strengthening and range-of-motion exercises. Vibration training may lead to faster and more complete proprioceptive recovery but further evidence is needed. CONCLUSIONS Several new modalities for rehabilitation after ACL reconstruction may be helpful but should not be performed to the exclusion of range-of-motion, strengthening, and functional exercises. Accelerated rehabilitation does not appear to be harmful but further investigation of rehabilitation timing is warranted. LEVEL OF EVIDENCE Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- L.M. Kruse
- Department of Orthopedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.W. Wright:
| | - B. Gray
- Department of Orthopedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.W. Wright:
| | - R.W. Wright
- Department of Orthopedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.W. Wright:
| |
Collapse
|
7
|
Kruse LM, Gray BL, Wright RW. Anterior Cruciate Ligament Reconstruction Rehabilitation in the Pediatric Population. Clin Sports Med 2011; 30:817-24. [DOI: 10.1016/j.csm.2011.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|