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Comparison between Immediate and Delayed Weight Bearing in Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction | ||
| Al- Anbar Medical Journal | ||
| Article 2, Volume 15, Issue 2, 2019, Pages 30-34 PDF (302.59 K) | ||
| Document Type: Original articles | ||
| DOI: 10.33091/amj.2019.170896 | ||
| Authors | ||
| Majed A. Alsaad* 1; Abdulkareem H. Alsaffa2; Mohammed S. Alharris1 | ||
| 1Department of Orthopedics, Baghdad Medical City Complex, Baghdad, Iraq | ||
| 2Department of Sports Medicine, Ministry of Health, Baghdad, Iraq | ||
| Abstract | ||
| Background: Anterior cruciate ligament (ACL) rupture is one of the most frequent orthopedic sports traumas. The treatment of choice for an ACL tear is ACL reconstruction and usually followed by 4-9 months of outpatient sports or orthopedic physical therapy. There are different exercises and regime variations in rehabilitation after surgery. Both weight-bearing and non-weight bearing exercises have been used and shown to be effective for rehabilitation in post ACL reconstruction and return to sport. Objectives: To compare the effect of immediate and delayed weight-bearing in a rehabilitation protocol after ACL reconstruction. Materials and Methods: Forty patients with an ACL injury with or without meniscal injury were included in the study. They divided into two groups, group A with immediate weight-bearing and group B delayed weight-bearing after surgery and we followed them with lysholm score and took results before surgery, after 3 months, and after 6 months from surgery. Results: Results of the mean value of lysholm score before surgery group A 65.40 and group B 66.90 with P-value 0.421, after 3 months group A 81.55 and group B 81.75 with P-value 0.904 and after 6 months from surgery group A 91.65 and group B 92.25 with P-value 0.675. Conclusion: There is no functional difference between immediate weight-bearing and delayed weight-bearing after ACL reconstruction. Clinically immediate weight-bearing better than delayed weight-bearing by improving muscle performance around the hip and knee and improve the condition of the cartilage, immediate weight-bearing not harmful on the knee joint or ACL graft. | ||
| Keywords | ||
| ACL reconstruction; Immediate weight-bearing; Arthroscopy; Delayed weightbearing | ||
| References | ||
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[1] L. Siegel, C. Vandenakker-Albanese, and D. Siegel, “Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management,” Clin. J. Sport Med., vol. 22, no. 4, pp. 349–355, 2012.
[2] S. M. Gianotti, S. W. Marshall, P. A. Hume, and L. Bunt, “Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study,” J. Sci. Med. Sport, vol. 12, no. 6, pp. 622–627, 2009.
[3] K. C. Miyasaka, “The incidence of knee ligament injuries in the general population,” Am J Knee Surg, vol. 1, pp. 43–48, 1991.
[4] J. P. Smith III and G. R. Barrett, “Medial and lateral meniscal tear patterns in anterior cruciate ligament-deficient knees: a prospective analysis of 575 tears,” Am. J. Sports Med., vol. 29, no. 4, pp. 415–419, 2001.
[5] A. F. Anderson, D. C. Dome, S. Gautam, M. H. Awh, and G. W. Rennirt, “Correlation of anthropometric measurements, strength, anterior cruciate ligament size, and intercondylar notch characteristics to sex differences in anterior cruciate ligament tear rates,” Am. J. Sports Med., vol. 29, no. 1, pp. 58–66, 2001.
[6] N. G. H. Mohtadi, D. S. Chan, K. N. Dainty, and D. B. Whelan, “Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults,” Cochrane database Syst. Rev., no. 9, 2011.
[7] B. D. Beynnon and B. C. Fleming, “Anterior cruciate ligament strain in-vivo: a review of previous work,” J. Biomech., vol. 31, no. 6, pp. 519–525, 1998.
[8] A. Benjaminse, A. Gokeler, and C. P. van der Schans, “Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis,” J. Orthop. Sport. Phys. Ther., vol. 36, no. 5, pp. 267–288, 2006.
[9] J. A. Ostrowski, “Accuracy of 3 diagnostic tests for anterior cruciate ligament tears,” J. Athl. Train., vol. 41, no. 1, p. 120, 2006.
[10] M. F. Sherman, R. F. Warren, J. L. Marshall, and G. J. Savatsky, “A clinical and radiographical analysis of 127 anterior cruciate insufficient knees.,” Clin. Orthop. Relat. Res., vol. 227, pp. 229–237, 1988.
[11] K. P. Spindler and R. W. Wright, “Anterior cruciate ligament tear,” N. Engl. J. Med., vol. 359, no. 20, pp. 2135–2142, 2008.
[12] S. Lyman, P. Koulouvaris, S. Sherman, H. Do, L. A. Mandl, and R. G. Marx, “Epidemiology of anterior cruciate ligament reconstruction: trends, readmissions, and subsequent knee surgery,” JBJS, vol. 91, no. 10, pp. 2321–2328, 2009.
[13] E. Linko, A. Harilainen, A. Malmivaara, and S. Seitsalo, “Surgical versus conservative interventions for anterior cruciate ligament ruptures in adults,” Cochrane Database Syst. Rev., no. 2, 2005.
[14] J. C. Christensen, L. R. Goldfine, and H. S. West, “The effects of early aggressive rehabilitation on outcomes after anterior cruciate ligament reconstruction using autologous hamstring tendon: a randomized clinical trial,” J. Sport Rehabil., vol. 22, no. 3, pp. 191–201, 2013.
[15] W. Wang, L. Liu, X. Chang, Z. Y. Jia, J. Z. Zhao, and W. D. Xu, “Cross-cultural translation of the Lysholm knee score in Chinese and its validation in patients with anterior cruciate ligament injury,” BMC Musculoskelet. Disord., vol. 17, no. 1, p. 436, 2016.
[16] L. PAULOS and J. R. ANDREWS, “Anterior cruciate ligament strain and tensile forces for weight-bearing and non–weight-bearing exercises: a guide to exercise selection,” J. Orthop. Sport. Phys. Ther., vol. 42, no. 3, p. 209, 2012.
[17] D. Adams, D. Logerstedt, A. Hunter-Giordano, M. J. Axe, and L. Snyder-Mackler, “Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression,” J. Orthop. Sport. Phys. Ther., vol. 42, no. 7, pp. 601–614, 2012.
[18] F. M. Azar, S. T. Canale, and J. H. Beaty, Campbell’s operative orthopaedics e-book. Elsevier Health Sciences, 2016.
[19] B. C. Fleming, P. A. Renstrom, B. D. Beynnon, B. Engstrom, and G. Peura, “The influence of functional knee bracing on the anterior cruciate ligament strain biomechanics in weightbearing and nonweightbearing knees,” Am. J. Sports Med., vol. 28, no. 6, pp. 815–824, 2000.
[20] M. G. Papandreou, E. V Billis, E. M. Antonogiannakis, and N. A. Papaioannou, “Effect of cross exercise on quadriceps acceleration reaction time and subjective scores (Lysholm questionnaire) following anterior cruciate ligament reconstruction,” J. Orthop. Surg. Res., vol. 4, no. 1, p. 2, 2009.
[21] H. J. Ra, H. S. Kim, J. Y. Choi, J. K. Ha, J. Y. Kim, and J. G. Kim, “Comparison of the ceiling effect in the Lysholm score and the IKDC subjective score for assessing functional outcome after ACL reconstruction,” Knee, vol. 21, no. 5, pp. 906–910, 2014.
[22] D. Celik, D. Coşkunsu, and Ö. Kılıçoğlu, “Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability,” Clin. Orthop. Relat. Res., vol. 471, no. 8, pp. 2602–2610, 2013.
[23] L. M. Kruse, B. Gray, and R. W. Wright, “Rehabilitation after anterior cruciate ligament reconstruction: a systematic review,” J. Bone Joint Surg. Am., vol. 94, no. 19, p. 1737, 2012.
[24] B. D. Beynnon et al., “Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind investigation evaluating knee joint laxity using roentgen stereophotogrammetric analysis,” Am. J. Sports Med., vol. 39, no. 12, pp. 2536–2548, 2011. | ||
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