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Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol

Introduction: The Purpose of the present study was to assess the outcome of anterior cruciate ligament reconstruction (ACLR) with an accelerated rehabilitation protocol and to compare it to a conservative rehabilitation protocol. It was hypothesized that an accelerated rehabilitation protocol, inclu...

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Autores principales: Deichsel, Adrian, Oeckenpöhler, Simon, Raschke, Michael J., Grunenberg, Ole, Peez, Christian, Briese, Thorben, Herbst, Elmar, Kittl, Christoph, Glasbrenner, Johannes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380741/
https://www.ncbi.nlm.nih.gov/pubmed/37510682
http://dx.doi.org/10.3390/jcm12144567
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author Deichsel, Adrian
Oeckenpöhler, Simon
Raschke, Michael J.
Grunenberg, Ole
Peez, Christian
Briese, Thorben
Herbst, Elmar
Kittl, Christoph
Glasbrenner, Johannes
author_facet Deichsel, Adrian
Oeckenpöhler, Simon
Raschke, Michael J.
Grunenberg, Ole
Peez, Christian
Briese, Thorben
Herbst, Elmar
Kittl, Christoph
Glasbrenner, Johannes
author_sort Deichsel, Adrian
collection PubMed
description Introduction: The Purpose of the present study was to assess the outcome of anterior cruciate ligament reconstruction (ACLR) with an accelerated rehabilitation protocol and to compare it to a conservative rehabilitation protocol. It was hypothesized that an accelerated rehabilitation protocol, including brace-free early weight bearing, would result in a higher rate of recurrent instability and revision surgery compared to a conservative rehabilitation protocol. Methods: From 2016 to 2017, two different rehabilitation protocols for isolated ACLR were used at a high-volume knee surgery center. A total of 65 consecutive patients with isolated hamstring ACLR, of whom n = 33 had been treated with an accelerated (AccRehab) and n = 32 with a conservative rehabilitation protocol (ConRehab), were retrospectively included in the study. Patients were evaluated for recurrent instability, revision surgery, and other complications at a mean follow-up period of 64 ± 7.4 months. In addition, Tegner Activity Scale, Lysholm Score, and IKDC-subjective Score were evaluated. Statistical comparison between the two groups was performed utilizing Fisher’s exact test and Student’s t-test. Results: Mean age (29.3 vs. 26.6 years) and preoperative Tegner Score (6.4 vs. 5.9) were comparable between both groups. At 64 ± 7.4 months after ACLR, six cases of recurrent instability were reported in the AccRehab group (18%) in comparison to three cases (9%) in the ConRehab group (p = n.s.). There was no significant difference regarding revision surgery and further complications. Furthermore, no significant difference was found between both groups regarding Tegner (5.5 ± 1.9 vs. 5.5 ± 1.2), Lysholm (93.6 ± 6.3 vs. 89.3 ± 10.7), and IKDC score (89.7 ± 7.9 vs. 86.7 ± 12.1). Conclusion: No significant disadvantage of an accelerated rehabilitation protocol following ACLR was found in terms of recurrent instability rate, revision surgery, or patient-reported outcome. However, a trend towards a higher reinstability rate was found for an accelerated rehabilitation protocol. Future level one trials evaluating brace-free early weight bearing following ACLR are desirable.
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spelling pubmed-103807412023-07-29 Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol Deichsel, Adrian Oeckenpöhler, Simon Raschke, Michael J. Grunenberg, Ole Peez, Christian Briese, Thorben Herbst, Elmar Kittl, Christoph Glasbrenner, Johannes J Clin Med Article Introduction: The Purpose of the present study was to assess the outcome of anterior cruciate ligament reconstruction (ACLR) with an accelerated rehabilitation protocol and to compare it to a conservative rehabilitation protocol. It was hypothesized that an accelerated rehabilitation protocol, including brace-free early weight bearing, would result in a higher rate of recurrent instability and revision surgery compared to a conservative rehabilitation protocol. Methods: From 2016 to 2017, two different rehabilitation protocols for isolated ACLR were used at a high-volume knee surgery center. A total of 65 consecutive patients with isolated hamstring ACLR, of whom n = 33 had been treated with an accelerated (AccRehab) and n = 32 with a conservative rehabilitation protocol (ConRehab), were retrospectively included in the study. Patients were evaluated for recurrent instability, revision surgery, and other complications at a mean follow-up period of 64 ± 7.4 months. In addition, Tegner Activity Scale, Lysholm Score, and IKDC-subjective Score were evaluated. Statistical comparison between the two groups was performed utilizing Fisher’s exact test and Student’s t-test. Results: Mean age (29.3 vs. 26.6 years) and preoperative Tegner Score (6.4 vs. 5.9) were comparable between both groups. At 64 ± 7.4 months after ACLR, six cases of recurrent instability were reported in the AccRehab group (18%) in comparison to three cases (9%) in the ConRehab group (p = n.s.). There was no significant difference regarding revision surgery and further complications. Furthermore, no significant difference was found between both groups regarding Tegner (5.5 ± 1.9 vs. 5.5 ± 1.2), Lysholm (93.6 ± 6.3 vs. 89.3 ± 10.7), and IKDC score (89.7 ± 7.9 vs. 86.7 ± 12.1). Conclusion: No significant disadvantage of an accelerated rehabilitation protocol following ACLR was found in terms of recurrent instability rate, revision surgery, or patient-reported outcome. However, a trend towards a higher reinstability rate was found for an accelerated rehabilitation protocol. Future level one trials evaluating brace-free early weight bearing following ACLR are desirable. MDPI 2023-07-09 /pmc/articles/PMC10380741/ /pubmed/37510682 http://dx.doi.org/10.3390/jcm12144567 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Deichsel, Adrian
Oeckenpöhler, Simon
Raschke, Michael J.
Grunenberg, Ole
Peez, Christian
Briese, Thorben
Herbst, Elmar
Kittl, Christoph
Glasbrenner, Johannes
Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol
title Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol
title_full Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol
title_fullStr Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol
title_full_unstemmed Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol
title_short Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol
title_sort recurrent instability rate and subjective knee function following accelerated rehabilitation after acl reconstruction in comparison to a conservative rehabilitation protocol
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380741/
https://www.ncbi.nlm.nih.gov/pubmed/37510682
http://dx.doi.org/10.3390/jcm12144567
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