Dataset Information

Rehabilitation Principles to Consider for Anterior Cruciate Ligament Repair.

ABSTRACT:

Context

Injury to the anterior cruciate ligament (ACL) is among the most common orthopaedic injuries, and reconstruction of a ruptured ACL is a common orthopaedic procedure. In general, surgical intervention is necessary to restore stability to the injured knee, and to prevent meniscal damage. Along with surgery, intense postoperative physical therapy is needed to restore function to the injured extremity. ACL reconstruction (ACLR) has been the standard of care in recent decades, and advances in surgical technology have reintroduced the prospect of augmented primary repair of the native ACL via a variety of methods.

Evidence acquisition

A search of PubMed database of articles and reviews available in English was performed through 2020. The search terms ACLR, anterior cruciate ligament repair, bridge enhanced acl repair, suture anchor repair, dynamic intraligamentary stabilization, internal bracing, suture ligament augmentation, and internal brace ligament augmentation were used.

Study design

Clinical review.

Level of evidence

Level 5.

Results

No exact consensus exists on effective rehabilitation protocols after ACL repair techniques, as the variation in published protocols seem even greater than the variation in those for ACLR. For some techniques such as internal bracing and dynamic interligamentary stabilization, it is likely permissible for the patients to progress to full weightbearing and discontinue bracing sooner. However, caution should be applied with regard to earlier return to sport than after ACLR as to minimize risk for retear.

Conclusion

More research is needed to address how physical therapies must adapt to these innovative repair techniques. Until that is accomplished, we recommend that physical therapists understand the differences among the various ACL surgery techniques discussed here and work with the surgeons to develop a rehabilitation protocol for their mutual patients.

Strength of recommendation taxonomy (sort)

SUBMITTER: Wu J

PROVIDER: S-EPMC9112707 | biostudies-literature | 2022 May-Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Rehabilitation Principles to Consider for Anterior Cruciate Ligament Repair.

Wu Jocelyn J Kator Jamie L JL Zarro Michael M Leong Natalie L NL

Sports health 20210803 3

<h4>Context</h4>Injury to the anterior cruciate ligament (ACL) is among the most common orthopaedic injuries, and reconstruction of a ruptured ACL is a common orthopaedic procedure. In general, surgical intervention is necessary to restore stability to the injured knee, and to prevent meniscal damage. Along with surgery, intense postoperative physical therapy is needed to restore function to the injured extremity. ACL reconstruction (ACLR) has been the standard of care in recent decades, and adv ...[more]

PMID: 34344237

Similar Datasets

Project description:BackgroundPre- and postoperative rehabilitation are important to the management of patients with anterior cruciate ligament (ACL) reconstruction, but little attention has been given to the costs. This study evaluated the pre- and postoperative rehabilitation charges in patients with ACL reconstruction in the United States.HypothesisPatients receive preoperative rehabilitation less commonly than postoperative rehabilitation.Study designRetrospective database study.Level of evidenceLevel 4.MethodsUsing the PearlDiver database, we identified patients undergoing ACL reconstruction from 2007 through 2011 using Current Procedural Terminology codes. The associated rehabilitation charges billed to insurance providers for 90 days preoperatively and 6 months postoperatively were categorized as physical therapy or as durable medical equipment (DME). The charges were examined by year and geographic region and represented as per-patient average charges (PPACs).ResultsA total of 92,179 patients were identified in the study period. The PPAC for rehabilitation was $241 during the 90-day preoperative period and $1876 for the 6-month postoperative period. Patients averaged 2 preoperative sessions for physical therapy, with 44% of patients receiving preoperative rehabilitation in contrast with an average of 17 postoperative sessions per patient in 93% of patients. Rehabilitation charges were greater postoperatively than preoperatively (P < 0.05). Preoperatively, 24% of patients received a DME, while 35% received a DME postoperatively. Preoperative rehabilitation PPACs were highest in the Northeast, followed by Midwest, South, and West (P < 0.05). There were no significant differences in postoperative rehabilitation PPACs for geographic region (P = 0.43).ConclusionPreoperative rehabilitation charges were lower than postoperative charges. A patient undergoing ACL reconstruction typically received 9 times more sessions of postoperative physical therapy than preoperative.Clinical relevanceThis study found that preoperative supervised rehabilitation for patients with ACL reconstruction was infrequent across the United States.

Dataset Information

Rehabilitation Principles to Consider for Anterior Cruciate Ligament Repair.

Context

Evidence acquisition

Study design

Level of evidence

Results

Conclusion

Strength of recommendation taxonomy (sort)

Publications

Rehabilitation Principles to Consider for Anterior Cruciate Ligament Repair.

Similar Datasets

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