Category Archives: Knee Surg Sports Traumatol Arthrosc

Superior return to sports rate after patellar tendon autograft over patellar tendon allograft in revision anterior cruciate ligament reconstruction.

Superior return to sports rate after patellar tendon autograft over patellar tendon allograft in revision anterior cruciate ligament reconstruction.

Knee Surg Sports Traumatol Arthrosc. 2017 Jun 17;:

Authors: Keizer MNJ, Hoogeslag RAG, van Raay JJAM, Otten E, Brouwer RW

Abstract
PURPOSE: After revision anterior cruciate ligament reconstruction (ACLR), the rate of return to the pre-injury type of sport (RTS type) is low and graft choice might be an important factor. The aim of this study was to determine whether there is a difference in outcome after revision ACLR using a patellar tendon allograft compared to an ipsilateral patellar tendon autograft. It was hypothesized that the rate of RTS type using an ipsilateral patellar tendon autograft will be superior to using patellar tendon allograft.
METHODS: The design is a retrospective cohort study. Inclusion criteria were patients who underwent revision ACLR with a minimum follow-up of 1 year after revision using a patellar allograft or ipsilateral autograft. Primary study parameter was rate of RTS type. Secondary study parameters were RTS level, subscores of the KOOS, the IKDCsubjective, the Tegner score and reasons for no RTS.
RESULTS: Eighty-two patients participated in this study (36 allografts and 46 autografts). In patients with a minimum follow-up of 1 year, rate of RTS type was 51.4% for the patellar tendon allograft and 62.8% for the patellar tendon autograft group (n.s.). In patients with a minimum follow-up rate of 2 years, rate of RTS type was 43.3 versus 75.0%, respectively (p = 0.027). No differences in secondary study parameters were found. In patients with a minimum follow-up of 1 year, rate of RTS type was significantly higher (p = 0.025) for patients without anxiety compared to patients who were anxious to perform certain movements.
CONCLUSION: After a minimum follow-up of 2 years, rate of RTS type is in favour of using an ipsilateral patellar tendon autograft when compared to using a patellar tendon allograft in patients undergoing revision ACLR; after a minimum follow-up of 1 year, no significant difference was found. In revision ACLR, the results of this study might influence graft choice in favour of autologous graft when the use of an allograft or autograft patellar tendon is considered.
LEVEL OF EVIDENCE: III.

PMID: 28624854 [PubMed – as supplied by publisher]

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Motor learning strategies in basketball players and its implications for ACL injury prevention: a randomized controlled trial.

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Motor learning strategies in basketball players and its implications for ACL injury prevention: a randomized controlled trial.

Knee Surg Sports Traumatol Arthrosc. 2015 Aug 11;

Authors: Benjaminse A, Otten B, Gokeler A, Diercks RL, Lemmink KA

Abstract
PURPOSE: Adding external focus of attention (EF, focus on the movement effect) may optimize current anterior cruciate ligament (ACL) injury prevention programmes. The purpose of the current study was to investigate the effects of an EF, by a visual stimulus and an internal focus, by a verbal stimulus during unexpected sidestep cutting in female and male athletes and how these effects remained over time.
METHODS: Ninety experienced basketball athletes performed sidestep cutting manoeuvres in three sessions (S1, S2 and S3). In this randomized controlled trial, athletes were allocated to three groups: visual (VIS), verbal (VER) and control (CTRL). Kinematics and kinetics were collected at the time of peak knee frontal plane moment.
RESULTS: Males in the VIS group showed a larger vertical ground reaction force (S1: 25.4 ± 3.1 N/kg, S2: 25.8 ± 2.9 N/kg, S3: 25.2 ± 3.2 N/kg) and knee flexion moments (S1: -3.8 ± 0.9 Nm/kg, S2: -4.0 ± 1.2 Nm/kg, S3: -3.9 ± 1.3 Nm/kg) compared to the males in the VER and CTRL groups and to the females in the VIS group (p < 0.05). Additionally, the males in the VIS group reduced knee valgus moment and the females in the VER group reduced knee varus moment over time (n.s.).
CONCLUSION: Male subjects clearly benefit from visual feedback. Females may need different feedback modes to learn a correct movement pattern. Sex-specific learning preferences may have to be acknowledged in day by day practice. Adding video instruction or feedback to regular training regimens when teaching athletes safe movement patterns and providing individual feedback might target suboptimal long-term results and optimize ACL injury prevention programmes.
LEVEL OF EVIDENCE: I.

PMID: 26259551 [PubMed – as supplied by publisher]

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No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: a randomized controlled trial.

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No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: a randomized controlled trial.

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2026-32

Authors: van der Worp H, Zwerver J, Hamstra M, van den Akker-Scheek I, Diercks RL

Abstract
PURPOSE: The aim of the study was to compare the effectiveness of focused shockwave therapy (FSWT) and radial shockwave therapy (RSWT) for treating patellar tendinopathy.
METHODS: Patients were randomized into two groups. One group received three sessions of FSWT, and the other group received three sessions of RSWT. Both groups also received an eccentric training programme. Follow-up measurements took place 1, 4, 7 and 14 weeks after the final shockwave treatment. The primary outcome measure was the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire. Secondary outcome measures were pain during ADL, sports activities and the decline squat.
RESULTS: Forty-three subjects (57 tendons) were included in the study. Twenty-one subjects (31 tendons) received FSWT, and 22 subjects (26 tendons) received RSWT. Both groups improved significantly on the VISA-P score, but there were no differences in improvement between the FSWT group (15 points on the VISA-P) and the RSWT group (9.6 points, n.s.). This was also the case for the secondary outcome measures.
CONCLUSION: There were no statistically significant differences in effectiveness between FSWT and RSWT. It is therefore not possible to recommend one treatment over the other on grounds of outcome. Both groups improved significantly, although it is questionable whether this difference is clinically relevant.
LEVEL OF EVIDENCE: II.

PMID: 23666379 [PubMed – indexed for MEDLINE]

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Immersive virtual reality improves movement patterns in patients after ACL reconstruction: implications for enhanced criteria-based return-to-sport rehabilitation.

Immersive virtual reality improves movement patterns in patients after ACL reconstruction: implications for enhanced criteria-based return-to-sport rehabilitation.

Knee Surg Sports Traumatol Arthrosc. 2014 Oct 14;

Authors: Gokeler A, Bisschop M, Myer GD, Benjaminse A, Dijkstra PU, van Keeken HG, van Raay JJ, Burgerhof JG, Otten E

Abstract
PURPOSE: The purpose of this study was to evaluate the influence of immersion in a virtual reality environment on knee biomechanics in patients after ACL reconstruction (ACLR). It was hypothesized that virtual reality techniques aimed to change attentional focus would influence altered knee flexion angle, knee extension moment and peak vertical ground reaction force (vGRF) in patients following ACLR.
METHODS: Twenty athletes following ACLR and 20 healthy controls (CTRL) performed a step-down task in both a non-virtual reality environment and a virtual reality environment displaying a pedestrian traffic scene. A motion analysis system and force plates were used to measure kinematics and kinetics during a step-down task to analyse each single-leg landing.
RESULTS: A significant main effect was found for environment for knee flexion excursion (P = n.s.). Significant interaction differences were found between environment and groups for vGRF (P = 0.004), knee moment (P < 0.001), knee angle at peak vGRF (P = 0.01) and knee flexion excursion (P = 0.03). There was larger effect of virtual reality environment on knee biomechanics in patients after ACLR compared with controls.
CONCLUSION: Patients after ACLR immersed in virtual reality environment demonstrated knee joint biomechanics that approximate those of CTRL. The results of this study indicate that a realistic virtual reality scenario may distract patients after ACLR from conscious motor control. Application of clinically available technology may aid in current rehabilitation programmes to target altered movement patterns after ACLR.
LEVEL OF EVIDENCE: Diagnostic study, Level III.

PMID: 25311052 [PubMed – as supplied by publisher]

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ESWT for tendinopathy: technology and clinical implications.

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ESWT for tendinopathy: technology and clinical implications.

Knee Surg Sports Traumatol Arthrosc. 2013 Jun;21(6):1451-8

Authors: van der Worp H, van den…

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Quadriceps function following ACL reconstruction and rehabilitation: implications for optimisation of current practices.

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Quadriceps function following ACL reconstruction and rehabilitation: implications for optimisation of current practices.

Knee Surg Sports Traumatol Arthrosc. 2013…

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ACL injury prevention, more effective with a different way of motor learning?

ACL injury prevention, more effective with a different way of motor learning?
Knee Surg Sports Traumatol Arthrosc. 2011 Apr;19(4):622-7
Authors: Benjaminse A, Otten E
Abstract
PURPOSE: What happens to the tran… Continue reading

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