Rehabilitation After ACL Injury Essay

Objectives: To evaluate clinically and radiologically the long-term results of ACL reconstruction with a hamstring graft.

There are different techniques that repair a torn ACL. The popular method for surgeons is the patellar tendon graft procedure. This type of ACL replacement uses the middle third of the person’s own patellar tendon and replacing the damage tendon with it. The advantages are that the fixation is very strong and the patellar tendon replacing

Recovering from a serious knee injury and returning to pre-injury levels can be a difficult task to overcome, but it has been proven possible to do this. Improper injury protocols and the injuries themselves are two of the largest factors in professional athletes not having elongated and successful careers. ACL, MCL, PCL, LCL, and Patellar Tendonitis are the most common knee injuries in which athletes sustain. Sustaining a knee injury at the highest and most competitive levels of basketball can make the injury and recovery process much more difficult and stressful, however. Depending on the injury, it can take a very extended amount of time for the knee to return back to its normal functioning, especially since damaging one part of the knee does not come without other injuries. A permanent and career ending injury may be the result if the proper percussions are not taken throughout the recovery process.

The purpose of ACL reconstruction is to restore function by repairing normal movements, replicate knee anatomy, and to protect the knee for a long duration. More specifically, the dimensions, orientation, and insertion sites of the ACL must be restored. To ensure this, future consideration for improvement of ACL reconstruction surgery is vital.

With an ever increasing number of people becoming involved with athletic activities, there is an increasing number of injuries occurring which can be devastating for the individual. Most of the injuries that affect athletes occur in one of four structures in the human body: bones, muscles, tendons, or ligaments. Because ligaments attach bone to bone and play a major part in providing stability for joints, the major stabilizing ligament in the knee, the anterior cruciate ligament (ACL), assists in performing everyday actions of the human body including sitting, standing, walking, running, dancing, and participating in other sports. The injury that specifically affects this ligament is very serious and always

This study included 28 patients who underwent ACL surgery performed by the same 2 surgeons and standard rehab protocol was done in the same physical therapy clinic, with all the same exercises and progressions. The Battery Test uses exercise analysis to grade the participants. The exercises include measurement of isokinetic strength, single hop for distance, triple hop, side hop, and a jump-landing assessment. There were also patient surveys that asses their feelings about the overall health of their knee. The participants completed this testing 6 months after surgery, which is the average RTP time frame for basic ACL rehab protocol. Out of all 28 patients, only 2 individuals passed this test and can be considered safe for RTP. This information is extremely important for anyone who has the authority to grant RTP to any athlete. Allowing patients back to play too soon is extremely dangerous and can cause further injury. Using this specific test to determine RTP decisions is a great technique to utilize in athletic

When someone tears their ACL, their first thought goes to getting ACL surgery, or ACLR. However, there are non-surgical treatments for special populations. Those populations are young children and older individuals. Additionally, there are alternatives to ACLR.

Every Tuesday and Thursday, Dr. Alpert wakes up at 6:30 AM, which allows him enough time to brew his morning coffee and prepare for the day all before making his first cut in the operating room at 8:00 AM. He performs his surgeries at either Ashton Surgical Center in Hoffman Estates, IL on Tuesday, or at Algonquin Road Surgical Center in Lake In the Hills, IL on Thursday. “I typically have surgeries from eight in the morning to about two in the afternoon, which allows three to five patients per day depending on the procedure. Every time I have an ACL reconstruction, I turn on my some of my favorite oldies music to get me in the groove.” During a typical ACL reconstruction, Dr. Alpert scrapes out the old, ruptured ACL and swaps it with a graft that is most commonly obtained from the hamstring or the patellar tendon. “I prefer to use the hamstring, especially with women. The procedure classically takes about an hour and a half to complete, and the patient is able to start rehab the next day. With ACL tears being such a frequent injury among female athletes, particularly in non-contact sports, it is currently being researched just why that is.”

The ACL is one of the most common injuries today, but in the past it was rare to have this type of injury. Warren states, “Whereas in the 1970’s HSS performed about five ACL procedures a year, today that number is closer to 100,000 a year.” Today it is very common for teenage boys and girls to play the same sports. According to Department of Orthopedic Surgery at the University of California college, “ACL injury is most prevalent (1 in 1,750 persons) in patients 15-45 years of age.” The average person is more active in the age range of 15 through 45 so this is why the ACL injuries are more likely to happen within this age gap. Department of Orthopedic Surgery, also explains, “ACL injury has an annual incidence of more than 200,000 cases with

INCREASE IN TEARS Anterior cruciate ligament injuries are receiving a great deal of notice because of the incidence of injury that occurs not only in the athletic population but also in those individuals who are recreationally active (Russell, 2006). Each year in the United States there are approximately 250,000 ACL injuries. This is approximately 1 in 3,000 in the general population (Boden, 2000). Of these injuries, about 175,000 require reconstructive surgery. These surgeries had an estimated cost of over two billion dollars annually in the United States (Yu, 2007). These statistics alone make it obvious that this injury occurs very often. The ACL is one of the most commonly disrupted ligaments in the knee. While the prevalence of the injury has increased, so has the number of athletes in the world since ACL injury research first began. Women are now allowed to participate in sports and new sports are being participated in

Imagine an athlete at the top of their game coming to a sudden halt because of a life-altering injury, tearing their Anterior Cruciate Ligament (ACL). This happens to athletes everywhere because of lack of awareness and lack of prevention. To a non-athlete, this injury might not sound life-altering, but when an athlete hears that they have torn their ACL, they know that there will be a hard journey in front of them. Until an athlete endures the hardships of recovering from this injury, they do not understand the intricacies and the pains that an athlete endures when facing this game-changing injury. Not all athletes can avoid an ACL injury by preventative strengthening exercises, so they must endure a long process of recovery in order

The main focus in the first stage of the rehabilitation problem will be to get 100% range of movement back into the athletes injured knee with no pain being suffered as he currently only has 70% range of movement and 2 months post-surgery the Fowler Kennedy Sport Medicine Clinic suggest that he should have full range of movement (ROM) in his knee (Werstin, 2009). It will hope to achieve this by introducing closed kinetic chain exercises (CKC) which are exercises that use a resistance such as squats and bicycling (Heijne et al, 2004) but also must remember that it is just as vital to maintain the highest level of strength and function possible in the unaffected knee as well, this is important as during the program we will use the unaffected leg as a comparison to assess the progress of the affected knee (Hiemstra et al, 2000). These have been chosen as according to Fleming et al 2003, CKC

Jong Ra et al.’s (2014) study measured the ceiling effects of the Lysholm score and the IKDC subjective score when utilized for evaluating functional outcomes post-ACL reconstruction and compared their concurrent validity by assessing the correlation of each score with a one-leg hop test. This was a retrospective study, consisting of 134 participants who underwent an ACL reconstruction between May 2007 and April 2011. The authors of this study set up the inclusion criteria as an ACL rupture with or without a meniscus tear and participation in the 6 and 12-month evaluation. The study sample consisted of 134 participants, including 111 males and 23 females with an average age of 27.2 years who underwent ACL reconstruction with a single-bundle hamstring autograft. A subgroup evaluation was done for subjects who were not athletically active but only participated in recreational sports and had a pre-injury Tegner score of 6 or less. The recreational sports subgroup consisted of 100 subjects with an average age of 28.6 years and an average Tegner score of 5.1.

ACL injuries used to be seen as career ending injuries 50 years ago, however, throughout the years with the advancement in technology aiding treatment and rehabilitation procedures. Yet they are still sever and take months to recover. This is because of the precise location of the ligament within the knee joint. Resulting in no blood clot formation within the joint as a consequence scar tissue will not form and the tissue will just be filled with uncontrolled blood leading to swelling an pain within the joint (ACL reconstruction Oxford university hospital, 2017) which is why it takes between 9 to 12 months for recovery. With an ACL injury, other injuries often follow, namely MCL injuries and meniscal lesions which in time would likely lead to the patient contracting osteoarthritis due to it being a degenerative disorder consequently resulting from the meniscal and

Anterior cruciate ligament injury (ACL) is the most common knee related injury. (Agel, Arendt, & Bershadsky, 2005) The purpose of the literature review is to identify if ACL reconstruction gives patients the highest chance of returning to their pre-injury level of activity. Using various search engines, such as Cochrane, EBSCO Host, Medline, Toronto Notes 2014, and UpToDate, the following keywords were applied anterior cruciate ligament injury, ACL reconstruction, ACL rehabilitation, ACL injury outcomes. With this several appropriate research papers where found that help discuss this topic. Results have shown that surgical measures have shown the best outcomes for patient that want to return for a high level of activity, but for patients