Title: How Much to Expect in ACL-Reconstruction, MCL Repair and Meniscus Rasping – Two years follow up with Specific Evidence Based Exercises

Authors: Dr S.S.Subramanian, Dr S. Beula Subaranjani

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.128

Abstract

   

Road traffic accidents are commonly recorded in developing countries. Rehabilitation after knee surgeries needs to be established with patient centric approach. Aims & Objectives of this research was to analyse the efficacy of protocol based exercises plus problem based exercises on a subject post ACL – reconstruction, medial meniscus rasping and medical ligament repair.

Materials & Methodology: She was treated during the period from (3rd Post-Operative Day) 08.07.2017 till 30.9.2019. A part from protocol based exercises, core strengthening and exercises to both upper extremities and contra lateral leg were used. With weekly thrice frequency of 25-30 minutes / session.

Results: Pre and Post womac score and obesity has shown P<.05 and clinical prognosis were discussed with evidence.

Conclusion: Outcome of this study findings can be validated for application in rehabilitation of similar knee surgery subjects.

Keywords: ACL – R – Anterior Cruciate Ligament - Rehabilitation

References

  1. Hertel, H Behrend, T Cierpinski, V Musahl… - Knee Surgery, Sports 2005  ACL reconstruction using bone-patellar tendon-bone press-fit fixation: 10-year clinical results May 2005, Volume 13, Issue 4, pp 248-255
  2. Shelbourne, P Nitz - The American journal of sports …, 1990 - journals.sagepub.com Accelerated rehabilitation after anterior cruciate ligament reconstruction volume: 18 issue: 3, page(s): 292-299
  3. Paulos, DC Wnorowski, CL Beck - Sports medicine, 1991 Rehabilitation Following Knee Surgery April 1991, Volume 11, Issue 4, pp 257–275
  4. Wilk, MM Reinold, TR Hooks - The Orthopedic clinics of North …, 2003 - europepmc.org Recent advances in the rehabilitation of isolated and combined anterior cruciate ligament injuries. [01 Jan 2003, 34(1):107-137]
  5. Lephart, DM Pincivero… - The American journal …, 1997 - journals.sagepub.com The Role of Proprioception in the Management and Rehabilitation of Athletic Injuries. volume: 25 issue: 1, page(s): 130-137 Issue published: January 1, 1997
  6. Kegler, C Escoffery, I Alcantara… - International…, 2008M- ijbnpa.biomedcentral.com A qualitative examination of home and neighborhood environments for obesity prevention in rural adults. International Journal of Behavioral Nutrition and Physical Activity volume 5, Article number: 65 (2008)
  7. Griffith CJ, Wijdicks CA, LaPrade RF, Armitage BM, Johansen S, Engebretsen L. Force measure- ments on the posterior oblique ligament and superficial medial collateral ligament proximal and distal divisions to applied loads. Am J Sports Med. 2009;37:140-148. http://dx.doi.
  8. Wijdicks CA, Griffith CJ, Johansen S, Enge- bretsen L, La Prade RF. Injuries to the medial collateral ligament and associated medial structures of the knee. J Bone Joint Surg Am. 2010;92:1266-1280. http://dx.doi.org/10.2106/ JBJS.I.01229
  9. Grant JA, Tannenbaum E, Miller BS, et al. Treatment of combined complete tears of the anterior cruciate and medial collateral ligaments. Arthroscopy 2012;28:110-22.
  10. Wirth CJ. The meniscus: structure, morphology and function. Knee. 1996;3:57-58
  11. Karahan M, Kocaoglu B, et al. Effect of partial medial meniscectomy on the proprioceptive function of the knee. Arch Orthop Trauma Surg. 2010;130(3):427–431. doi: 10.1007/s00402-009-1018-2.
  12. Warren RF, Marshall J. Injuries of the anterior cruciate ligament and medial collateral ligament of the knee. Clin Orthop. 1978;136:191.
  13. Howell GED. Clinical presentation of the knee. In: Bulstrode CJK, Buckwalter J, Carr A, Marsh L, Fairbank J, Wilson-MacDonald J, Bouden G, editors. Oxford textbook of orthopedics and trauma. New York: Oxford University Press; 2002. pp. 1108–1113.
  14. Malempati, DO; John Jurjans, PT, ATC, SCS; Brian Noehren, PT, PhD; Mary L. Ireland, MD; Darren L. Johnson, MD Current Rehabilitation Concepts for Anterior Cruciate Ligament Surgery in Athletes Orthopedics. 2015;38(11):689-696, November 11, 2015
  15. Malone T. Anterior cruciate ligament rehabilitation. In: Johnson DL, Mair SD, eds. Clinical Sports Medicine. Philadelphia, PA: Elsevier; 2006:655-656.
  16. Wilk, Kevin E.a | Keirns, Michael A.a | Andrews, James R.a; | Clancy, William G.a; Arrigo, Christopher A. | Erber, Donna J.a; Journal: Isokinetics and Exercise Science,  Anterior Cruciate Ligament Reconstruction Rehabilitation: A Six-Month Followup of Isokinetic Testing in Recreational Athletes. vol. 1, no. 1, pp. 36-43, 1991 Accepted October 1990 | Published: 1 January 1991.
  17. Shelbourne KD, Nitz P. Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med. 1990: 18(3):292-299.
  18. Shelbourne KD, Klotz C. What I have learned about the ACL: utilizing a progressive rehabilitation scheme to achieve total knee symmetry after anterior cruciate ligament reconstruction. J Orthop Sci. 2006; 11(3):318-325.
  19. Meunier A, Odensten M, Good L. Long-term results after primary repair or non-surgical treatment of anterior cruciate ligament rupture: a randomized study with a 15-year follow-up. Scand J Med Sci Sports. 2007 Jun;17(3):230-7.
  20. Fithian DC, Paxton EW, Stone ML, Luetzow WF, Csintalan RP, Phelan D, Daniel DM. Prospective trial of a treatment algorithm for the management of the anterior cruciate ligament-injured knee. Am J Sports Med. 2005 Mar;33(3):335-46.
  21. McDaniel, JTB Dameron - The Journal of bone and joint …, 1980 - europepmc.org. Untreated ruptures of the anterior cruciate ligament.A follow-up study.The Journal of Bone and Joint Surgery. American Volume [01 Jul 1980, 62(5):696-705]
  22. Shi, J Li, H Zhai, H Wang, H Meng… - … rehabilitation, 2012 - content.iospress.com. Specialized core stability exercise: A neglected component of anterior cruciate ligament rehabilitation programs .Journal of Back and Musculoskeletal Rehabilitation, vol. 25, no. 4, pp. 291-297, 2012 Published: 28 November 2012
  23. Panchal Priyanka, Bedekar Nilima, Sancheti Parag, First Published December 1, 2017 Effects of Lumbar Core Stability Exercise Programme on Knee Pain, Range of Motion, and Function Post Anterior Cruciate Ligament Reconstruction Volume 23 Issue 1, December 2017
  24. Mall NA, Chalmers PN, Moric M, Tanaka MJ, Cole BJ, Bach BR Jr2, Paletta GA Jr4. Incidence and trends of anterior cruciate ligament reconstruction in the United States. 2014 Oct;42(10):2363-70. doi: 10.1177/0363546514542796. Epub 2014 Aug 1.
  25. Myer GD1, Paterno MV, Ford KR, Hewett TE. 2008. Neuromuscular training techniques to target deficits before return to sport after anterior cruciate ligament reconstruction . Jun;42(6):394-412.
  26. Renstrom P, Ljungqvist A, 11on page 1on page 1on page 1on page 1 (lee)Arendt E, Beynnon B, Fukubayashi T, Garrett W, Georgoulis T, Hewett TE, Johnson R, Krosshaug T, Mandelbaum B, Micheli L, Myklebust G, Roos E, Roos H, Schamasch P, Shultz S, Werner S, Wojtys E, Engebretsen L.Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med 2008;42:394–412
  27. Wojtys EM, Huston L, Boynton MD,et al. The effect of menstrual cycle on anterior cruciate ligament in women as determined by hormone levels. Am J Sports Med 2002;30:182–8.
  28. Rodeo SA, Arnoczky SP, Torzilli PA et al (1993) Tendonhealing in a bone tunnel. A biomechanical and histological study in the dog. J Bone Joint Surg Am 75(12):1795–1803
  29. Matsumoto A, et al. A comparison of bone-patellar tendon-bone and bone-hamstring tendon-bone autografts for anterior cruciate ligament reconstruction. Am J Sports Med. 2006;34(2):213–219. doi: 10.1177/0363546505279919.
  30. Lee, Adam Margalit, Afam Nduaguba2, Melissa A Gunderson2 and Lawrence Wells. Obesity and recovery of muscle strength after anterior cruciate ligament reconstruction in pediatric patients. Journal of Orthopaedic Surgery: 2018 - 26(3) 1–6.
  31. Laprade RF, Wijdicks CA. Surgical technique: development of an anatomic medial knee reconstruction. Clin Orthop Relat Res 2012;470:806-14.
  32. Sankar WN, et al. Combined anterior cruciate ligament and medial collateral ligament injuries in adolescents. J Pediatr Orthop. 2006;26(6):733–6.
  33. Cavanaugh & Sarah E. Killian. Rehabilitation following meniscal repair. Curr Rev Musculoskelet Med (2012) 5:46–58
  34. Cavanaugh JT. Rehabilitation following meniscal surgery. In: Engle RP, editor. Knee Ligament Rehabilitation. New York: Churchill Livingston; 1991. p. 59–69.
  35. Belzer J, Cannon W. Meniscal tears: treatment in the stable and unstable knee. Journal of the American Academy of Orthopedic Surgeons. 1993;1(1):41–7.
  36. Uchio Y, Ochi M, Adachi N, et al. Results of rasping of meniscal tears with and without anterior cruciate ligament injury as evaluated by second-look arthroscopy. Arthroscopy. 2003;19(5):463–9.
  37. Cavanaugh JT. Rehabilitation for non operative and operative management of knee injuries. In: Callaghan J, Simonian P, Wickiewicz T, editors. The adult knee. Lipponcott: Wilkens Publishers; 2003. p. 380–430.
  38. Barber SD, Noyes FR, Mangine RE, et al. Quantitative assessment of functional limitations in normal and anterior cruciate ligament deficient knees. Clin 1990;255:204–14.

Corresponding Author

Dr S.S.Subramanian, M.P.T (Orthopaedics), M.S (Education), M. Phil (Education), Ph.D (Physiotherapy)

The Principal, Sree Balaji College Of physiotherapy, Chennai – 100. Affiliated To (Bharath) University, BIHER, Chennai – 73.