Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries - Differentiation Based on Tendon Graft and Concomitant Injuries

URN to cite this document:

urn:nbn:de:bvb:355-epub-521228 Copy

DOI to cite this document:

10.5283/epub.52122 Copy

Memmel, Clemens ; Krutsch, Werner ; Szymski, Dominik ; Pfeifer, Christian ; Henssler, Leopold ; Frankewycz, Borys ; Angele, Peter ; Alt, Volker ; Koch, Matthias

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Date of publication of this fulltext: 06 Apr 2022 12:09

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Details

Item type:	Article
Open Access Type:	Gold (with APC)
Höhe Gebühr (aus OpenAPC):	2414.0
Institution der Zahlung:	Regensburg U
Journal or Publication Title:	International Journal of Environmental Research and Public Health
Publisher:	MDPI
Place of Publication:	BASEL
Volume:	19
Number of Issue or Book Chapter:	7
Page Range:	p. 4060
Date:	29 March 2022
Institutions:	Medicine > Lehrstuhl für Unfallchirurgie Medicine > Lehrstuhl für Kinder- und Jugendmedizin Medicine > Lehrstuhl für Orthopädie
Identification Number:	Value Type 10.3390/ijerph19074060 DOI
Keywords:	ACL RECONSTRUCTION; STRENGTH; WEIGHTBEARING; PRINCIPLES; anterior cruciate ligament reconstruction; early rehabilitation; hamstring tendon graft; bone tendon-bone graft; patella tendon graft
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Partially
Item ID:	52122

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Abstract

Background: Although anterior cruciate ligament reconstruction (ACLR) is a well-established procedure and is standardly performed by orthopedic surgeons all over the world, there does not seem to be a standard protocol for early rehabilitation. The purpose of this study was to give answers to the following questions: (i) Does (a) the use of a specific tendon graft, and (b) potentially additional ...

Abstract

Background: Although anterior cruciate ligament reconstruction (ACLR) is a well-established procedure and is standardly performed by orthopedic surgeons all over the world, there does not seem to be a standard protocol for early rehabilitation. The purpose of this study was to give answers to the following questions: (i) Does (a) the use of a specific tendon graft, and (b) potentially additional therapy of concomitant pathologies influence surgeons' choice of a distinct postoperative rehabilitation protocol after ACLR? (ii) To what extent do these rehabilitation recommendations differ? Methods: Retrospective analysis of currently used early rehabilitation protocols after ACLR in German-speaking countries (GER, AUT and SUI) was conducted. Rehabilitation criteria included weight bearing, range of motion (ROM), the utilization of braces, continuous passive/active motion therapy (CPM/CAM), rehabilitation training and sport-specific training. Tendon grafts were differentiated as hamstring (HAM) and bone-patellar tendon-bone grafts (BTB). Concomitant pathologies included meniscus injuries (+M) and unhappy triad injuries (+UTI). Results: Most of the surveyed protocols were differentiated according to the used tendon graft or additional therapy of concomitant injuries (ACLR-differentiated, n = 147 vs. ACLR without graft differentiation, n = 58). When comparing ACLR-HAM and ACLR-BTB, significant differences were found regarding weight bearing (p = 0.01), ROM (p = 0.05) and the utilization of braces (p = 0.03). Regarding ACLR+M, an overall significant decelerated rehabilitation could be detected. After ACLR+UTI-therapy, a significant delayed start to full weight bearing (p = 0.002) and ROM (p < 0.001) was found. Conclusions: Most orthopedic surgeons from German-speaking countries differentiate early rehabilitation after ACLR according to the tendon graft used and therapy of concomitant pathologies. No consensus about early rehabilitation after ACLR is available. However, tendencies for an accelerated rehabilitation after ACLR-BTB and a more restrained rehabilitation of multiple injured knees were detected.

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Metadata last modified: 19 Apr 2022 16:14

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