Patellofemoral Problems After Intraarticular Anterior Cruciate Ligament Reconstruction

Aglietti, Paolo; Buzzi, Roberto; D'andria, S.; Zaccherotti, G.

doi:10.1097/00003086-199303000-00025

Cited by 180 publications

(103 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, important intrinsic factors are increased body mass index, female gender and increased age [40,41]. Additional intrinsic factors of AKP could be potentially the presence of trochlear dysplasia and patella alta, which in the present study showed an increased incidence among patients undergoing ACL reconstruction.…”

Section: Discussionmentioning

confidence: 57%

The incidence of trochlear dysplasia in anterior cruciate ligament tears

Ntagiopoulos¹,

Bonin²,

Sonnery‐Cottet

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose The purpose of the present epidemiologic study is to record the radiographic presence of trochlear dysplasia and patella alta in patients who undergo anterior cruciate ligament (ACL) reconstruction as a potential underlying factor for postoperative anterior knee pain (AKP). Methods All consecutive cases of skeletally-mature ACLdeficient knees that would undergo ACL reconstruction in three different hospitals were prospectively included during a six-month period. Inclusion criteria were acute and subacute ACL injury with no previous ipsilateral knee operation. Patients with chronic ACL tears, prior-to-ACL-injury history of patellar instability or other PF disorders were excluded from the study. Results A total of 299 knees were included (mean age 32± ten years). Forty-four (14.7 %) knees had a positive 'crossing sign' in the lateral X-rays and 255 (85.3 %) had no sign of trochlear dysplasia (p<0.01). Among the cases with trochlear dysplasia, 41 (93 %) had type A trochlear dysplasia with the presence only of the 'crossing sign' and three (7 %) had type C trochlear dysplasia. Patellar height results included a mean Caton-Deschamps index of 1.0± 0.14 (0.5-1.4). Twenty (6.6 %) knees had an index of less than 0.8, and two (0.6 %) knees had an index less than 0.6. In contrast, 15 (5.0 %) knees had an abnormal value of more than 1.2, indicating patella alta. ConclusionsThe most important finding of the study is the increased prevalence of trochlear dysplasia and patella alta in patients with ACL injury, when compared to the incidence of trochlear dysplasia and patella alta in the general population in the literature. This finding could sound as an alert of a possible additional risk factor for post-operative anterior knee pain after ACL reconstruction.

show abstract

Section: Discussionmentioning

confidence: 57%

The incidence of trochlear dysplasia in anterior cruciate ligament tears

Ntagiopoulos¹,

Bonin²,

Sonnery‐Cottet

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Operasyon sonrası gelişen diz önü ağrısının diğer önemli bir nedeni de operasyon sonrası görülen eklem hareket açıklığı kısıtlılıklarıdır (32,(36)(37)(38). Ekstansiyon kaybının diz önü ağrısına neden olduğu birçok araştırmacı tarafından bildirilmiştir (32,36,38).…”

Section: Discussionunclassified

“…Ekstansiyon kaybının diz önü ağrısına neden olduğu birçok araştırmacı tarafından bildirilmiştir (32,36,38). Eklem hareket açıklığı kaybı diz fonksiyonları için zararlıdır ve mutlaka kaçınılmalıdır (32).…”

Section: Discussionunclassified

Ön Çapraz Bağ Rekonstrüksiyonu Sonrası Gelişen Diz Önü Ağrısının Kas Gücü, Fonksiyonel Skorlar, Denge ve Propriosepsiyon Üzerine Etkisi

Gülbahar¹,

Akgün²,

Karasel³

et al. 2013

Tftr

View full text Add to dashboard Cite

ÖzetAmaç: Bu çalışmanın amacı patellar tendon (PT) otogrefti ile ön çapraz bağ (ÖÇB) rekonstrüksiyonu yapılmış olgularda diz önü ağrısının klinik sonuçlara, aktivite düzeyine, kas gücü, fonksiyonel testler, propriosepsiyon ve denge üzerine etkisinin araştırılmasıdır. Gereç ve Yöntem: PT grefti ile ÖÇB rekonstrüksiyonu yapılmış ve hızlandırılmış rehabilitasyon programı uygulanmış yaş ortalaması 27,6 olan 38 hasta çalışmaya alındı. Hastaların izokinetik diz ekstansör ve fleksör kas güçleri Cybex ® izokinetik dinamometre ile ölçüldü. Statik denge Sport-KAT ® ile değerlendirildi. Proprioseptif fonksiyonları da izokinetik test ve tedavi cihazı ile 90 derece diz fleksiyonundan sırası ile 40, 20 ve 5 dereceye aktif repozisyonlama şeklinde değerlendirildi. Fonksiyonel kapasiteleri tek adım, üç adım ve çapraz atlama mesafeleri ile değerlendirildi. Subjektif semptomları Lysholm skalası, aktivite düzeyleri Tegner aktivite skalasıyla ölçüldü. Diz önü ağrısı 10 santimetrelik vizüel analog skala ile değerlendirildi. Bulgular: Çalışmaya alınan 38 hastanın 15'inde (%39,5) diz önü ağrısı kaydedildi. Diz önü ağrısı olan hastaların Lysholm, Tegner skorları diz önü ağrısı olmayan gruba göre anlamlı olarak düşük saptandı (p<0,05). İzokinetik kas gücü değerlendirmeleri, fonksiyonel testleri, denge değerlendirmeleri ve propriosepsiyon ölçümlerinde iki grup arasında istatistiksel olarak anlamlı fark saptanmadı (p>0,05). Tüm değerlendirmeler için güç analizi yapıldı. Sonuç: PT otogrefti ile ÖÇB rekonstrüksiyonu sonrası gelişen diz önü ağrısının; Lysholm ve Tegner aktivite skorlarını etkilerken, kas gücü, denge, propriosepsiyon, ve fonksiyonel durumlarını etkilemediği görülmüştür. Türk Fiz T›p Re hab Derg 2013;59:90-6. Anah tar Ke li me ler: Ön çapraz bağ, rekonstrüksiyon, diz önü ağrısı, patellofemoral ağrı, patellar tendon otogrefti Sum maryObjective: The aim of this study was to evaluate the effect of anterior knee pain on clinical outcome, activity level, strength, functional tests, proprioception, and balance in patients who had anterior cruciate ligament (ACL) reconstruction with a patellar tendon (PT) autograft. Materials and Methods: Thirty-eight patients with a mean age of 27,6, who had undergone ACL reconstruction with a PT autograft and followed with a modified accelerated rehabilitation program, were included in the study. Isokinetic muscle strength of knee extension and flexion were measured using a Cybex ® isokinetic dynamometer. Sport-KAT ® device was used to assess the static balance. For proprioceptive assessment, an isokinetic dynamometer was used. Active repositioning was measured at knee flexions of 40°, 20°, and 5°. Activity level of the patients was assessed with Tegner activity scale and subjective functional results were evaluated using the Lysholm knee score. Single leg hop, triple leg hop, and one-legged crossover hop tests were used for objective functional testing. Anterior knee pain was evaluated with a 1-10 centimeters visual analog scale. Results: Fifteen patients (39.5%) had anterior knee pain. Lysholm and...

show abstract

“…ROM was limited in the early phase of rehabilitation due to restrictions given by the surgeon to protect the healing ligaments and was fully recovered by 8 weeks. Anterior knee pain has frequently been reported following ACL reconstruction 1,42 and primary repair, 27,43 and has been linked to anterior interval scarring and patellar tendon adhesion. 1,37 For this reason, patellar mobilizations were initiated immediately postoperatively and were an integral component of treatment throughout the initial phases of treatment.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation Following a Minimally Invasive Procedure for the Repair of a Combined Anterior Cruciate and Posterior Cruciate Ligament Partial Rupture in a 15-Year-Old Athlete

Beecher¹,

Garrison²,

Wyland³

2010

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

response to facilitate healing. 3,5,34 Murray et al 34 examined the histological changes seen in 23 ruptured anterior cruciate ligaments (ACLs) and found that the healing ligament forms a layer of synovial tissue over its ruptured surface that may impede repair and result in ligament retraction. Of note, none of the ACLs in this study demonstrated tissue bridging between the ruptured tibial and femoral remnants. Studies comparing the intrinsic properties of the injured ACL and medial collateral ligament reveal that fibroblasts of the ACL demonstrate lower proliferation, lower migration potential, and lower response to growth factors. 36,48,55 Likewise, fibroblasts within cruciate ligaments synthesize nitric oxide, a free radical that has been shown to inhibit synthesis of both collagen and proteoglycan in larger amounts when compared to cells of the medial collateral ligament.10 Collectively, these results indicate a lower overall healing potential for the cruciate ligaments.Articular cartilage has similar difficulties in healing potential and exhibits limited potential for repair due to its avascular nature and the inability of chondrocytes to mount a sufficient T he poor healing potential of injured cruciate ligaments has been well documented. 4,5,9,26,45 Failure to completely heal is thought to be due to inhibitory effects of the intra-articular environment, such as a lack of cytokine stimulation and poor hematoma formation. 3,5,34 In addition, the cruciate ligaments appear to have an inherent inability to produce a significant t sTuDy DEsign: Case report.t BaCKgrounD: The healing response procedure is a minimally invasive arthroscopic surgical technique used to stimulate healing in the treatment of partial cruciate ligament tears. The purpose of this report is to provide information on the surgical procedure, the postoperative rehabilitation, and the overall functional results in a patient who underwent such a procedure.t CasE DEsCriPTion: A 15-year-old male, who sustained a partial tear of both the anterior cruciate and posterior cruciate ligament while playing football, underwent arthroscopic surgical management utilizing a healing response technique. Precautions concerning range of motion and resisted activities were followed postoperatively to protect the healing cruciate ligaments. The postoperative protocol consisted of 3 phases, culminating in return-to-sport training. Treatment incorporated cardiovascular, proprioceptive, strength, power, plyometric, and sport-specific activities. Treatment was progressed based on specific criteria emphasizing proper movement patterns and eccentric control during functional activities.

show abstract

Patellofemoral Problems After Intraarticular Anterior Cruciate Ligament Reconstruction

Cited by 180 publications

References 0 publications

The incidence of trochlear dysplasia in anterior cruciate ligament tears

The incidence of trochlear dysplasia in anterior cruciate ligament tears

Ön Çapraz Bağ Rekonstrüksiyonu Sonrası Gelişen Diz Önü Ağrısının Kas Gücü, Fonksiyonel Skorlar, Denge ve Propriosepsiyon Üzerine Etkisi

Rehabilitation Following a Minimally Invasive Procedure for the Repair of a Combined Anterior Cruciate and Posterior Cruciate Ligament Partial Rupture in a 15-Year-Old Athlete

Contact Info

Product

Resources

About