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

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 fo...

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Autores principales: Memmel, Clemens, Krutsch, Werner, Szymski, Dominik, Pfeifer, Christian, Henssler, Leopold, Frankewycz, Borys, Angele, Peter, Alt, Volker, Koch, Matthias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8997891/
https://www.ncbi.nlm.nih.gov/pubmed/35409745
http://dx.doi.org/10.3390/ijerph19074060
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author Memmel, Clemens
Krutsch, Werner
Szymski, Dominik
Pfeifer, Christian
Henssler, Leopold
Frankewycz, Borys
Angele, Peter
Alt, Volker
Koch, Matthias
author_facet Memmel, Clemens
Krutsch, Werner
Szymski, Dominik
Pfeifer, Christian
Henssler, Leopold
Frankewycz, Borys
Angele, Peter
Alt, Volker
Koch, Matthias
author_sort Memmel, Clemens
collection PubMed
description 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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spelling pubmed-89978912022-04-12 Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries Memmel, Clemens Krutsch, Werner Szymski, Dominik Pfeifer, Christian Henssler, Leopold Frankewycz, Borys Angele, Peter Alt, Volker Koch, Matthias Int J Environ Res Public Health Article 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. MDPI 2022-03-29 /pmc/articles/PMC8997891/ /pubmed/35409745 http://dx.doi.org/10.3390/ijerph19074060 Text en © 2022 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
Memmel, Clemens
Krutsch, Werner
Szymski, Dominik
Pfeifer, Christian
Henssler, Leopold
Frankewycz, Borys
Angele, Peter
Alt, Volker
Koch, Matthias
Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries
title Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries
title_full Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries
title_fullStr Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries
title_full_unstemmed Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries
title_short Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries—Differentiation Based on Tendon Graft and Concomitant Injuries
title_sort current standards of early rehabilitation after anterior cruciate ligament reconstruction in german speaking countries—differentiation based on tendon graft and concomitant injuries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8997891/
https://www.ncbi.nlm.nih.gov/pubmed/35409745
http://dx.doi.org/10.3390/ijerph19074060
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