Two different 12-week-physiotherapy programmes following ACL reconstruction have the same affect on muscle strength, dynamic balance and functional performance values in both groups. We considered that the practice of Wii Fit activities like conventional rehabilitation could also address physical therapy goals, which included improving visual-perceptual processing, coordination, proprioception and functional mobility.

Diagnostic study, Level I.

PurposeThe aim of the present study was to evaluate the clinical, radiological and functional results of patients underwent single-tunnel (ST) and double-tunnel (DT) medial patellofemoral ligament(MPFL) reconstructions with hamstring autograft following recurrent patella dislocation prospectively in a single institution. Methods From 2013 to 2017, 80 patients with symptomatic recurrent patellar dislocation or instability were randomly divided into 2 groups for MPFL reconstruction with ST technique or DT technique and evaluated prospectively. In the ST group, there were 20 male and 20 female with a median follow-up of 46.5 months (range 24-74). The median age was 15 years (range 10-28). In the DT group, there were 18 male and 22 female with a median follow-up of 40 months (range 24-74). The median age was 19 years (range 14-29). Clinical scores (Kujala score, Lysholm score, Tegner score and IKDC score) and radiological measurements (congruence angle and patellar tilt angle) of the patients were evaluated preoperatively and at postoperative 24th month. Isokinetic dynamometric tests were performed at postoperative 24th month and the diference between the operated leg and the non-operated leg was found as a percentage deicit. Results There were no postoperative complications, redislocation or subluxation in any patient. Kujala, Lysholm, Tegner and IKDC scores were better and statistically signiicant postoperatively in both groups (p < 0.05). However, there was no statistically signiicant diference between the groups (n.s.). The congruence angle and patellar tilt angle were found to be returned to normal values postoperatively, but there was no statistically signiicant diference between the groups (n.s.). There was no statistically signiicant diference between the two groups in isokinetic dynamometric tests performed as 60° lexion, 60° extension, 180° lexion and 180° extension (n.s.). Conclusion The present study is the irst that compared the clinical, radiological and functional results of the ST and DT techniques to date. Regardless of the number of the tunnels, similar results were obtained in ST and DT reconstruction using transpatellar tunnel technique. Level of evidence Level I.

Purpose The aim of this study was to investigate the efects of concentric and eccentric cross-education (CE) on quadriceps strength and knee function recoveries after anterior cruciate ligament (ACL) reconstruction. Methods Forty-eight patients (age: 29.5 ± 6.8 years, body mass index: 26.1 ± 3.2 kg/m 2 ) who had undergone ACL reconstruction with hamstring tendon autograft were included in the study. The patients were randomly divided into three groups when they reached four weeks post surgery: (1) concentric CE (n = 16); (2) eccentric CE (n = 16); and (3) control (n = 16). All groups followed the same post-surgical rehabilitation program for their reconstructed limb. Additionally, the two experimental groups followed eight weeks of isokinetic training for the uninjured knee at 60°/s for 3 days per week. Quadriceps maximum voluntary isometric strength (MVIC) was measured during the 4th week (pre-training), 12th week (post training), and 24th week post surgery. The single-leg hop distance and International Knee Documentary Committee (IKDC) scores were also evaluated during the 24th week post surgery. Analysis of variance was used for statistical analysis. Results Group-by-time interaction was signiicant for quadriceps MVICs for reconstructed and healthy limbs (p = 0.02). Quadriceps strength of both knees was greater in concentric and eccentric CE groups compared to control group during the 12th-and 24th weeks post surgery (p < 0.05). Strength gain was 28% and 31% in concentric and eccentric CE groups, respectively, when compared with the control group. Concentric and eccentric CE had similar efects on quadriceps strength recovery (n.s.). IKDC score, and single-leg hop distances were not signiicantly diferent among groups (n.s.). Conclusions Concentric and eccentric quadricep strengthening of healthy limbs in early phases of ACL rehabilitation improved post-surgical quadriceps strength recovery of the reconstructed limb. CE should be integrated into ACL reconstruction rehabilitation, especially in the early rehabilitative phases to restore quadriceps strength. Level of evidence Randomized controlled trial, Level I.

No abstract