ACL Rehabilitation: Re-injury and Return to Sport Tests: Difference between revisions
No edit summary |
No edit summary |
||
| Line 9: | Line 9: | ||
== ACL Re-injury == | == ACL Re-injury == | ||
Despite advancement in surgical procedures, outocmes following ACL-reconstruction continue to be poor. less than 50% of athletes are able to regain their pre-injury level of performance, and for thoses who returned successfully to sport re-injury remains a risk factor. | |||
Athletes who suffered ACL injuries are at risk of recurrence in the first year, and often in the second year, upon returning to play. The incidence of re-injury in the first two years following reconstruction is estimated to be 6 times greater than thise who didn't suffer ACL injury, this incidence is much higher in female athlets<ref name=":0">Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. The American journal of sports medicine. 2014 Jul;42(7):1567-73.</ref>. A study reported 29.5% ACL re-injury in the second year with 20% sustaining a contralateral injury<ref name=":0" />. The risk of re-injury extends up to 5 years following injury<ref>Salmon L, Russell V, Musgrove T, Pinczewski L, Refshauge K. Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2005 Aug 1;21(8):948-57.</ref>. | Athletes who suffered ACL injuries are at risk of recurrence in the first year, and often in the second year, upon returning to play. The incidence of re-injury in the first two years following reconstruction is estimated to be 6 times greater than thise who didn't suffer ACL injury, this incidence is much higher in female athlets<ref name=":0">Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. The American journal of sports medicine. 2014 Jul;42(7):1567-73.</ref>. A study reported 29.5% ACL re-injury in the second year with 20% sustaining a contralateral injury<ref name=":0" />. The risk of re-injury extends up to 5 years following injury<ref>Salmon L, Russell V, Musgrove T, Pinczewski L, Refshauge K. Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2005 Aug 1;21(8):948-57.</ref>. | ||
== | Risk factors of primary and second ACL injury have been investigated widely in the literature. Biomechanical factors such as abnormal loading distribution patters around the knee, increased external knee abduction moment in females<ref>Hewett, T.E., Myer, G.D., Ford, K.R., Heidt Jr, R.S., Colosimo, A.J., McLean, S.G., Van den Bogert, A.J., Paterno, M.V. and Succop, P., 2005. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. ''The American journal of sports medicine'', ''33''(4), pp.492-501.</ref>, side-to-side differences in lower extremities, frontal-plane displacement of the trunk<ref>Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. Deficits in neuromuscular control of the trunk predict knee injury risk: prospective biomechanical-epidemiologic study. The American journal of sports medicine. 2007 Jul;35(7):1123-30.</ref> and reduced lower extremity aflexor activation in vertical jump<ref>Hewett TE, Myer GD, Ford KR, Heidt Jr RS, Colosimo AJ, McLean SG, Van den Bogert AJ, Paterno MV, Succop P. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. The American journal of sports medicine. 2005 Apr;33(4):492-501.</ref> have been associated with ACL injury. | ||
=== Re-injury Risk Factors === | |||
Quadriceps weakness is a common persisting issue after surgery<ref>Hewett TE, Di Stasi SL, Myer GD. Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction. The American journal of sports medicine. 2013 Jan;41(1):216-24.</ref> which is manifested through abnormal loading patterns in gait and sports activities.A deficit of about 20% of quadriceps strength compared to he opposite side is found in athletes after ACL recosntruction. However, even a 90% quadriceps index is not neccesarily associated with normal neuro-muscular control. | |||
== Sub Heading 3 == | == Sub Heading 3 == | ||
Revision as of 18:57, 11 December 2018
Original Editor - Mariam Hashem
Top Contributors - Mariam Hashem, Kim Jackson, Tarina van der Stockt, Uchechukwu Chukwuemeka, Rucha Gadgil, Chelsea Mclene, Leana Louw, Wanda van Niekerk, Jess Bell, Olajumoke Ogunleye and Carin Hunter
Page is under work:
ACL Re-injury[edit | edit source]
Despite advancement in surgical procedures, outocmes following ACL-reconstruction continue to be poor. less than 50% of athletes are able to regain their pre-injury level of performance, and for thoses who returned successfully to sport re-injury remains a risk factor.
Athletes who suffered ACL injuries are at risk of recurrence in the first year, and often in the second year, upon returning to play. The incidence of re-injury in the first two years following reconstruction is estimated to be 6 times greater than thise who didn't suffer ACL injury, this incidence is much higher in female athlets[1]. A study reported 29.5% ACL re-injury in the second year with 20% sustaining a contralateral injury[1]. The risk of re-injury extends up to 5 years following injury[2].
Risk factors of primary and second ACL injury have been investigated widely in the literature. Biomechanical factors such as abnormal loading distribution patters around the knee, increased external knee abduction moment in females[3], side-to-side differences in lower extremities, frontal-plane displacement of the trunk[4] and reduced lower extremity aflexor activation in vertical jump[5] have been associated with ACL injury.
Re-injury Risk Factors[edit | edit source]
Quadriceps weakness is a common persisting issue after surgery[6] which is manifested through abnormal loading patterns in gait and sports activities.A deficit of about 20% of quadriceps strength compared to he opposite side is found in athletes after ACL recosntruction. However, even a 90% quadriceps index is not neccesarily associated with normal neuro-muscular control.
Sub Heading 3[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. The American journal of sports medicine. 2014 Jul;42(7):1567-73.
- ↑ Salmon L, Russell V, Musgrove T, Pinczewski L, Refshauge K. Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2005 Aug 1;21(8):948-57.
- ↑ Hewett, T.E., Myer, G.D., Ford, K.R., Heidt Jr, R.S., Colosimo, A.J., McLean, S.G., Van den Bogert, A.J., Paterno, M.V. and Succop, P., 2005. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. The American journal of sports medicine, 33(4), pp.492-501.
- ↑ Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. Deficits in neuromuscular control of the trunk predict knee injury risk: prospective biomechanical-epidemiologic study. The American journal of sports medicine. 2007 Jul;35(7):1123-30.
- ↑ Hewett TE, Myer GD, Ford KR, Heidt Jr RS, Colosimo AJ, McLean SG, Van den Bogert AJ, Paterno MV, Succop P. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. The American journal of sports medicine. 2005 Apr;33(4):492-501.
- ↑ Hewett TE, Di Stasi SL, Myer GD. Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction. The American journal of sports medicine. 2013 Jan;41(1):216-24.
