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Neira A, Silvestre R, Debandi A, Darras D, Cristi-Sánchez I, Barra I, Peñailillo L, De La Fuente C. Is the Rotatory Knee Stability Immediately Decreased Following a Competitive Soccer Match? Front Bioeng Biotechnol 2022; 10:903131. [PMID: 35935511 PMCID: PMC9354053 DOI: 10.3389/fbioe.2022.903131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Fatigue induced by soccer playing increases physical efforts, which might alter the transverse knee stability, a known factor that promotes knee injuries, particularly anterior cruciate ligament injury. Thereby, primarily, we aimed to determine whether rotatory knee stability decreases immediately following a competitive soccer match in amateur players. Furthermore, we assessed the role of the preferred and non-preferred limbs to kick a ball in rotatory knee stability and the correlation between performance parameters and rotatory knee stability. We hypothesized that the knee stability decreases immediately after a competitive soccer match in amateur players. Eight healthy amateur soccer players (aged 27.2 ± 4.7 years and with body mass index of 23.8 ± 1.2 kg m−2) were included immediately before and after a competitive soccer match. The rotatory knee stability was assessed in the preferred and non-preferred limbs through the acceleration and jerk of the pivot shift maneuver and by the internal knee rotation of a pivoting landing task. Two-way repeated-measures ANOVA for factors time (before and after the soccer match) and limb (preferred and non-preferred) and multiple comparisons were performed using α = 5%. There was a statistical significance for the main factor time in the acceleration (5.04 vs. 6.90 ms−2, Δ = 1.86 ms−2, p = 0.020, η2 = 0.331) and jerk (18.46 vs. 32.10 ms−2, Δ = 13.64 ms−2, p = 0.004, η2 = 0.456) of the pivot shift maneuver. Rotatory stability decreases following a competitive soccer match in amateur soccer players under fatigue. Both the acceleration and jerk during the pivot shift maneuver is increased without significant internal knee rotation changes during the pivoting landing task.
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Affiliation(s)
- Alejandro Neira
- Escuela Kinesiología, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
- *Correspondence: Alejandro Neira,
| | - Rony Silvestre
- Unidad de Biomecánica, Centro de Innovación, Clínica MEDS, Santiago, Chile
- Carrera de Kinesiología, Departamento de Cs. de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Aníbal Debandi
- Traumatología, Clínica MEDS, Santiago, Chile
- Servicio Traumatologéa, Hospital Clénico Universidad de Chile, Santiago, Chile
| | | | - Iver Cristi-Sánchez
- Laboratorio de Neuromecánica Aplicada, Escuela de Kinesiología, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Ignacio Barra
- Escuela Kinesiología, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Luis Peñailillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Carlos De La Fuente
- Unidad de Biomecánica, Centro de Innovación, Clínica MEDS, Santiago, Chile
- Carrera de Kinesiología, Departamento de Cs. de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratory of Neuromechanics, Universidade Federal do Pampa, Campus Uruguaiana, Uruguaiana, Brazil
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Deng Z, Zheng Y, Deng Z, Lu C, Wu Y, Chen K, Fu Z, Zhang H, Lu W, Zhu W. Arthroscopic reconstruction of anterior cruciate ligaments with allograft: single-tunnel single-bundle versus single-tunnel double-bundle techniques. J Orthop Traumatol 2022; 23:26. [PMID: 35759061 PMCID: PMC9237191 DOI: 10.1186/s10195-022-00649-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/12/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare the clinical results of anterior cruciate ligament (ACL) reconstruction using the single-tunnel single-bundle (STSB) technique versus the single-tunnel double-bundle (STDB) technique. Methods This was a retrospective, single-center, single-surgeon study based on data collected from March 2012 to June 2013. According to our inclusion/exclusion criteria, a total of 78 patients (64 males, 14 females; mean age, 25.1 years) who underwent arthroscopic ACL reconstruction with anterior tibialis tendon allografts through either the STSB technique (36 cases) or the STDB technique (42 cases) in our department were recruited. The International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores were used to evaluate the subjective function of the knee joint during the postoperative follow-up. The Lachman test and pivot shift test were used to objectively assess the stability of the knee. Results The average follow-up duration was 24.9 ± 1.8 months in the STSB group and 24.6 ± 1.7 months in the STDB group (P > 0.05). Patients in both groups recovered to the preoperative sports level with few complications. The postoperative Lysholm score (86.1 ± 7.5 vs. 47.7 ± 9.0 in the STSB group; 87.0 ± 7.1 vs. 48.2 ± 8.3 in the STDB group), IKDC score (87.8 ± 7.2 vs. 49.3 ± 6.1 in the STSB group; 88.7 ± 6.6 vs. 49.8 ± 6.3 in the STDB group), Tegner score (6.5 ± 1.3 vs. 2.5 ± 1.3 in the STSB group; 6.6 ± 1.2 vs. 2.6 ± 1.2 in the STDB group), Lachman test positive rate (8.3% vs. 89.9% in the STSB group; 7.1% vs. 85.7% in the STDB group), and pivot shift test positive rate (27.8% vs. 63.9% in the STSB group; 7.1% vs. 69.0% in the STDB group) were significantly improved compared to the preoperative status in both groups (P < 0.05). However, no statistically significant difference was observed between the two groups at the final follow-up (P > 0.05), except for the pivot shift test positive rate in the STDB group versus the STSB group (7.1% vs. 27.8%, P < 0.05). Conclusions The STDB technique achieved a satisfactory clinical outcome with better rotational stability compared to the traditional STSB technique and therefore provided an effective option for ACL reconstruction. Level of evidence Case series, Level IV.
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Affiliation(s)
- Zhenhan Deng
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China.,Guangxi University of Chinese Medicine, Nanning, 530200, Guangxi, China
| | - Yizi Zheng
- Guangxi University of Chinese Medicine, Nanning, 530200, Guangxi, China
| | - Zhiqin Deng
- Hand and Foot Surgery Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Changwei Lu
- Department of Spine and Joint Orthopedics, The People's Hospital of Hechi, Hechi, 547000, Guangxi, China
| | - Yihua Wu
- Department of Spine and Joint Orthopedics, The People's Hospital of Hechi, Hechi, 547000, Guangxi, China
| | - Kang Chen
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Zicai Fu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Hui Zhang
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Wei Lu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China.,Guangxi University of Chinese Medicine, Nanning, 530200, Guangxi, China
| | - Weimin Zhu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China. .,Guangxi University of Chinese Medicine, Nanning, 530200, Guangxi, China.
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Zhang Q, Yang Y, Li J, Zhang H, Fu Y, Wang Y. Functional double-bundle anterior cruciate ligament reconstruction using hamstring tendon autografts with preserved insertions is an effective treatment for tibiofemoral instability. Knee Surg Sports Traumatol Arthrosc 2019; 27:3471-3480. [PMID: 30796489 DOI: 10.1007/s00167-019-05401-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 02/06/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to introduce a modified anatomical anterior cruciate ligament reconstruction using functional double bundles (F-DBACLR), which achieved sequential tensioning at all flexion angles postoperatively, and compare its clinical outcomes with the anatomical single-bundle technique (A-SBACLR). METHODS A total of 156 patients with an ACL injury underwent ACLR (A-SB group, n = 78; F-DB group, n = 78). All operations were performed by anatomically identifying the ACL footprints and fixing the graft at a pre-determined degree of knee flexion. Two observers blinded to the patient identities examined the patients preoperatively and during follow-up (median 28.2 months; range 26-31 months). Multiple subjective and objective clinical evaluation tests and assessment of clinical outcomes concerning the translational and rotational stability of the knee including the International Knee Documentation Committee (IKDC) questionnaire, Lysholm Knee Scoring Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale, KT-1000 laxity measurements, Lachman test and pivot-shift test were performed preoperatively and postoperatively. RESULTS Preoperatively, no differences were found between the two groups. During the 2-year observation period, patients in the F-DB group revealed better clinical outcomes in terms of the Tegner Activity Scale Score, IKDC, KOOS and Lysholm Knee Scoring Scale. Similar results were shown in regard to the translational stability in both groups, while the F-DB group had more rotational stability at 2 years of follow-up. CONCLUSIONS The clinical outcomes indicated that F-DBACLR is clinically practicable and advantageous in the treatment of the ACL-deficient knee. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Qiang Zhang
- Department of Orthopedics, The General Hospital of Chinese People's Liberation Army, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
- Department of Orthopaedic Surgery, Royal Liverpool University Hospital, Prescot Street, Liverpool, UK.
| | - Yimeng Yang
- Department of Orthopedics, The General Hospital of Chinese People's Liberation Army, 28 Fuxing Road, Haidian District, Beijing, 100853, China
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Ji Li
- Department of Orthopedics, The General Hospital of Chinese People's Liberation Army, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hao Zhang
- Department of Orthopedics, The General Hospital of Chinese People's Liberation Army, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yangmu Fu
- Department of Orthopedics, The General Hospital of Chinese People's Liberation Army, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yan Wang
- Department of Orthopedics, The General Hospital of Chinese People's Liberation Army, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
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Connell R, Paton B, Milne R. Return to play following anterior cruciate ligament reconstruction: incorporating fatigue into a return to play functional battery. Part A: treadmill running. BMJ Open Sport Exerc Med 2019; 5:e000375. [PMID: 30899542 PMCID: PMC6407560 DOI: 10.1136/bmjsem-2018-000375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2019] [Indexed: 12/16/2022] Open
Abstract
Background The risk of reinjury and other sequelae following anterior cruciate ligament reconstruction (ACLR) remains high. Lack of knowledge regarding factors contributing to these risks limits our ability to develop sensitive return to play (RTP) tests. Using a running task, we evaluate whether fatigue induces alterations in foot progression angle (FPA), a proposed biomechanical risk factor and could be used to enhance RTP test sensitivity. Method Transverse plane foot kinematics (FPA) were assessed for 18 post-ACLR subjects during a treadmill running task, before and after a generalised lower limb fatigue protocol. Subject’s contralateral limbs were used as a control group. Results A small but significant difference between FPA for ACLR and contralateral limbs was observed before but not after fatigue. When confounding variables were considered, there was a significant difference in FPA change between ACLR and contralateral limbs from the prefatigue to postfatigue state. Conclusions Following ACLR athletes may develop a knee-protective movement strategy that delays the progression of osteoarthritis in the ACL-injured knee. This may, however, increase the risk of ACL reinjury. Following the onset of fatigue this proposed movement strategy, and thus osteoarthritis protection, is lost.
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Affiliation(s)
| | - Bruce Paton
- The Institute of Sport, Exercise & Health, London, UK
| | - Ross Milne
- The Institute of Sport, Exercise & Health, London, UK
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Lessi GC, Serrão FV. Effects of fatigue on lower limb, pelvis and trunk kinematics and lower limb muscle activity during single-leg landing after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2017; 25:2550-2558. [PMID: 26298713 DOI: 10.1007/s00167-015-3762-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Because there are no studies that have evaluated the effects of fatigue on the kinematics of the trunk and pelvis or on muscle activation in subjects with ACL reconstruction, the aim of this study was to evaluate the effects of fatigue on the lower limb, pelvis and trunk kinematics and lower limb muscle activation in subjects with ACL reconstruction during a single-leg landing compared to a healthy control group. METHODS The participants included 20 subjects with ACL reconstruction (ACL reconstruction group-ACLRG) and 20 healthy subjects (control group-CG) who were aged between 18 and 35 years. Kinematic and electromyographic analyses were performed during a single-leg landing before and after fatigue. The fatigue protocol included a series of 10 squats, two vertical jumps, and 20 steps. RESULTS The effects of fatigue were increased peak trunk flexion and increased activation of the vastus lateralis, biceps femoris (BF) and gluteus maximus (GMax) during the landing phase. CONCLUSION After the fatigue protocol, an increase in peak trunk flexion and activation of the GMax and BF were observed, most likely as a strategy to reduce the load on the ACL. ACL injury prevention programs should include strength and endurance exercises for the hip and trunk extensor muscles so that they can efficiently control trunk flexion during landing. LEVEL OF EVIDENCE Prospective comparative study, Level II.
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Affiliation(s)
- Giovanna Camparis Lessi
- Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luis, km 235, São Carlos, SP, CEP: 13565-905, Brazil
| | - Fábio Viadanna Serrão
- Department of Physical Therapy, Federal University of São Carlos, Rodovia Washington Luis, km 235, São Carlos, SP, CEP: 13565-905, Brazil.
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Culvenor AG, Perraton L, Guermazi A, Bryant AL, Whitehead TS, Morris HG, Crossley KM. Knee kinematics and kinetics are associated with early patellofemoral osteoarthritis following anterior cruciate ligament reconstruction. Osteoarthritis Cartilage 2016; 24:1548-53. [PMID: 27188685 DOI: 10.1016/j.joca.2016.05.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/18/2016] [Accepted: 05/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Patellofemoral osteoarthritis (PFOA) commonly occurs following anterior cruciate ligament reconstruction (ACLR). Our study aimed to compare knee kinematics and kinetics during a hop-landing task between individuals with and without early PFOA post-ACLR. DESIGN Forty-five individuals (mean ± SD 26 ± 5 years) 1-2 years post-ACLR underwent 3T isotropic MRI scans and 3D biomechanical assessment of a standardised forward hop task. Knee kinematics (initial contact, peak, excursion) in all three planes and sagittal plane kinetics (peak) were compared between 15 participants with early PFOA (MRI-defined patellofemoral cartilage lesion) and 30 participants with no PFOA (absence of patellofemoral cartilage lesion on MRI) using analysis of covariance (ANCOVA), adjusted for age, BMI, sex and the presence of early tibiofemoral OA. RESULTS Compared to participants without PFOA, those with early PFOA exhibited smaller peak knee flexion angles (mean difference, 95% confidence interval [CI]: -5.2°, -9.9 to -0.4; P = 0.035) and moments (-4.2 Nm/kg.m, -7.8 to -0.6; P = 0.024), and greater knee internal rotation excursion (5.3°, 2.0 to 8.6; P = 0.002). CONCLUSIONS Individuals with early PFOA within the first 2-years following ACLR exhibit distinct kinematic and kinetic features during a high-load landing task. These findings provide new information regarding common post-ACLR biomechanical patterns and PFOA. Since management strategies, such as altering knee load, are more effective during the early stages of disease, this knowledge will help to inform clinical management of early PFOA post-ACLR.
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Affiliation(s)
- A G Culvenor
- Paracelsus Medical University, Institute of Anatomy Salzburg & Nuremberg, Salzburg, Austria; La Trobe University, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Bundoora, Australia; Australian Hip and Knee Institute, Melbourne, Australia.
| | - L Perraton
- The University of Melbourne, Department of Physiotherapy, School of Medicine, Dentistry and Health Sciences, Parkville, Australia.
| | - A Guermazi
- Boston University School of Medicine, Department of Radiology, Boston, USA.
| | - A L Bryant
- The University of Melbourne, Department of Physiotherapy, School of Medicine, Dentistry and Health Sciences, Parkville, Australia.
| | - T S Whitehead
- OrthoSport Victoria, Epworth Richmond, Melbourne, Australia.
| | - H G Morris
- The Park Clinic, St Vincent's Private Hospital, Melbourne, Australia.
| | - K M Crossley
- La Trobe University, La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Bundoora, Australia.
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Is anterior cruciate ligament preservation surgery better than reconstructing both bundles? CURRENT ORTHOPAEDIC PRACTICE 2016. [DOI: 10.1097/bco.0000000000000375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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A systematic review of single- versus double-bundle ACL reconstruction using the anatomic anterior cruciate ligament reconstruction scoring checklist. Knee Surg Sports Traumatol Arthrosc 2016; 24:862-72. [PMID: 25344803 DOI: 10.1007/s00167-014-3393-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 10/15/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of this systematic review was to apply the anatomic ACL reconstruction scoring checklist (AARSC) and to evaluate the degree to which clinical studies comparing single-bundle (SB) and double-bundle (DB) ACL reconstructions are anatomic. METHODS A systematic electronic search was performed using the databases PubMed (MEDLINE), EMBASE and Cochrane Library. Studies published from January 1995 to January 2014 comparing SB and DB ACL reconstructions with clinical outcome measurements were included. The items from the AARSC were recorded for both the SB and DB groups in each study. RESULTS Eight-thousand nine-hundred and ninety-four studies were analysed, 77 were included. Randomized clinical trials (29; 38%) and prospective comparative studies (29; 38%) were the most frequent study type. Most studies were published in 2011 (19; 25%). The most commonly reported items for both SB and DB groups were as follows: graft type (152; 99%), femoral and tibial fixation method (149; 97% respectively), knee flexion angle during graft tensioning (124; 8%) and placement of the tibial tunnel at the ACL insertion site (101; 66%). The highest level of documentation used for ACL tunnel position for both groups was often one dimensional, e.g. drawing, operative notes or o'clock reference. The DB reconstruction was in general more thoroughly reported. The means for the AARSC were 6.9 ± 2.8 for the SB group and 8.3 ± 2.8 for the DB group. Both means were below a proposed required minimum score of 10 for anatomic ACL reconstruction. CONCLUSIONS There was substantial underreporting of surgical data for both the SB and DB groups in clinical studies. This underreporting creates difficulties when analysing, comparing and pooling results of scientific studies on this subject.
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Czamara A, Królikowska A, Szuba Ł, Widuchowski W, Kentel M. Single- vs. double-bundle anterior cruciate ligament reconstruction: a new aspect of knee assessment during activities involving dynamic knee rotation. J Strength Cond Res 2016; 29:489-99. [PMID: 25148470 DOI: 10.1519/jsc.0000000000000638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Few studies have compared single-bundle (SB) and double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) in the knee joint during activities involving change-of-direction maneuvers and knee rotation. This study examined whether the type of ACLR contributes to postphysiotherapy outcomes, with an emphasis on knee function assessment during activities involving dynamic knee rotation. Fifteen male patients after SB ACLR and 15 male patients after DB ACLR took part in the same physiotherapy program. Twenty-four weeks after ACLR, both groups underwent anterior laxity measurement, pivot shift tests, range of movement and joint circumference measurements, subjective assessment of pain and stability levels in the knee joint, peak torque measurement of the muscles rotating the tibia toward the femur, and a run test with maximal speed and change-of-direction maneuvers. Comparative analysis did not show any differences between the results of anterior tibial translation, pivot shift test, range of movement and joint circumference, and subjective assessment of pain and knee joint stability levels. No differences were noted between the groups in peak torque values obtained from the muscles responsible for internal and external tibial rotation or results of the run test. The data obtained from this study can be used by research teams to monitor and compare the effectiveness of various study protocols involving surgical and physiotherapy treatment. The data are especially useful when combined with the clinical assessment of patients who would like to return to sport.
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Affiliation(s)
- Andrzej Czamara
- 1The Department of Physiotherapy, The College of Physiotherapy in Wroclaw, Wroclaw, Poland; and 2The Department of Physiotherapy, The Center of Rehabilitation and Medical Education, Wroclaw, Poland
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Mayr HO, Benecke P, Hoell A, Schmitt-Sody M, Bernstein A, Suedkamp NP, Stoehr A. Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: A Comparative 2-Year Follow-up. Arthroscopy 2016; 32:34-42. [PMID: 26321112 DOI: 10.1016/j.arthro.2015.06.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 06/04/2015] [Accepted: 06/18/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare anatomic single-bundle (SB) versus double-bundle (DB) anterior cruciate ligament (ACL) reconstruction and to determine possible differences in clinical outcomes. METHODS In this prospective randomized study, 64 patients were divided into 2 equal groups. Anatomic SB and DB ACL reconstructions were performed using hamstring tendons. A follow-up examination 2 years after surgery comprised International Knee Documentation Committee (IKDC) 2000 assessment, Laxitester (ORTEMA Sport Protection, Markgröningen, Germany) measurement of anteroposterior translation regarding rotational stability, and radiographic evaluation. Statistical analysis and power calculation were performed (P < .05). RESULTS We examined 62 patients at a mean of 26 months (range, 23.3 to 32.7 months) after surgery. IKDC subjective and objective scores showed no significant differences when both groups were compared. The Laxitester measurements showed no significant differences regarding anteroposterior translation in the neutral position, internal rotation, and external rotation. However, there was a significant improvement in rotational laxity in external rotation in the DB group (P = .02). No differences were seen between the groups regarding osteoarthritic changes and tunnel widening. CONCLUSIONS There were no differences in IKDC subjective and objective scores between patients who underwent anatomic SB ACL reconstruction and those who underwent anatomic DB ACL reconstruction. LEVEL OF EVIDENCE Level I, prospective, randomized controlled clinical trial.
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Affiliation(s)
- Hermann O Mayr
- Department of Orthopedic and Trauma Surgery, Albert Ludwig University of Freiburg, Freiburg, Germany.
| | - Paul Benecke
- Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Anna Hoell
- Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Anke Bernstein
- Department of Orthopedic and Trauma Surgery, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Norbert P Suedkamp
- Department of Orthopedic and Trauma Surgery, Albert Ludwig University of Freiburg, Freiburg, Germany
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Tsarouhas A, Giakas G, Malizos KN, Spiropoulos G, Sideris V, Koutedakis Y, Hantes ME. Dynamic Effect of Quadriceps Muscle Activation on Anterior Tibial Translation After Single-Bundle and Double-Bundle Anterior Cruciate Ligament Reconstruction. Arthroscopy 2015; 31:1303-9. [PMID: 25882183 DOI: 10.1016/j.arthro.2015.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 02/01/2015] [Accepted: 02/16/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To examine differences in anterior tibial translation in 3 groups: single-bundle anterior cruciate ligament (ACL)-reconstructed, double-bundle ACL-reconstructed, and ACL-intact knees under gradual dynamic quadriceps muscle activation. METHODS Thirty male patients underwent successful single-bundle (n = 15) and double-bundle (n = 15) ACL reconstructions; 15 healthy controls were included in the study. Anterior tibial translation was assessed at 30° of knee flexion in the resting position (0% quadriceps activation) and under 50% and 100% of maximum quadriceps concentric contraction using an isokinetic dynamometer with the KT-2000 arthrometer securely attached to the participants' knees. RESULTS The 2 ACL-reconstructed groups were similar regarding International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Score (KOOS), Tegner, and Lysholm scores and preliminary isokinetic evaluation (P = .38). Quadriceps activation significantly affected anterior tibial translation (P = .001, α = 0.98). In all 3 study groups, anterior tibial translation was significantly higher under 100% quadriceps activation compared with 0% contraction (P = .01) and 50% quadriceps activation (P = .047). There were no between-group differences in anterior tibial translation with 0%, 50%, or 100% quadriceps activation (P = .46). CONCLUSIONS Under quadriceps muscle activation, anteroposterior knee laxity in ACL-intact and ACL-reconstructed knees is gradually increased. Single-bundle and double-bundle ACL-reconstructed knees show a similar increase in anterior tibial translation under gradual quadriceps contraction. When comparing different ACL reconstruction techniques in the experimental setting, dynamic, in addition to static, testing is advised to reach a comprehensive assessment of anteroposterior knee stability. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Alexander Tsarouhas
- Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
| | - Giannis Giakas
- Department of Physical Education and Sport Science, Center for Research and Technology of Thessaly, Trikala, Greece
| | - Konstantinos N Malizos
- Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Giannis Spiropoulos
- Department of Physical Education and Sport Science, Center for Research and Technology of Thessaly, Trikala, Greece
| | - Vasilios Sideris
- Department of Physical Education and Sport Science, Center for Research and Technology of Thessaly, Trikala, Greece
| | - Yiannis Koutedakis
- Department of Physical Education and Sport Science, Center for Research and Technology of Thessaly, Trikala, Greece
| | - Michael E Hantes
- Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Kinematics of Rotation in Joints of the Lower Limbs and Pelvis during Gait: Early Results-SB ACLR Approach versus DB ACLR Approach. BIOMED RESEARCH INTERNATIONAL 2015; 2015:707168. [PMID: 25922839 PMCID: PMC4397484 DOI: 10.1155/2015/707168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 01/21/2023]
Abstract
It is difficult to find publications comparing rotation kinematics in large joints of the lower limbs and pelvis during gait in patients after single-bundle (SB) reconstruction of the anterior cruciate ligament (ACLR) with double-bundle (DB) ACLR of the knee. The aim of this study was to compare rotation kinematics in ankle, knee, and hip joints and the pelvis during gait in the 14th week after SB and DB ACLR. The subjects were males after SB (n = 10) and DB (n = 13) ACLR and a control group (n = 15). The values of kinematic parameters were recorded during internal (IR) and external (ER) rotation in the joints during gait using the BTS SMART. The SB ACLR group obtained significantly higher values of ER in the involved knee comparing to DB ACLR and controls and excessive IR in the hip comparing to controls. In the DB ACLR group, excessive ER was noted in the involved leg's foot. Comparing with the DB ACLR and control groups, SB ACLR subjects had more substantial disorders of rotation kinematics in the lower limb joints. However, in both ACLR groups, 14 weeks of postoperative physiotherapy were not enough to fully restore rotation kinematics in joints of the lower limbs during gait.
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Culvenor AG, Schache AG, Vicenzino B, Pandy MG, Collins NJ, Cook JL, Crossley KM. Are Knee Biomechanics Different in Those With and Without Patellofemoral Osteoarthritis After Anterior Cruciate Ligament Reconstruction? Arthritis Care Res (Hoboken) 2014; 66:1566-70. [DOI: 10.1002/acr.22313] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Adam G. Culvenor
- The University of Queensland, School of Health and Rehabilitation Sciences; Brisbane, Queensland Australia
| | | | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences; Brisbane, Queensland Australia
| | | | | | - Jill L. Cook
- Monash University, School of Primary Health Care; Melbourne, Victoria Australia
| | - Kay M. Crossley
- The University of Queensland, School of Health and Rehabilitation Sciences; Brisbane, Queensland Australia
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