ArticleAn early return to vigorous activity may destabilize anterior cruciate ligaments reconstructed with hamstring grafts1
Section snippets
Participants
Inclusion criteria for our study were (1) unilateral ACL rupture without posterior cruciate ligament injury or collateral ligament injury requiring surgery; (2) positive presurgical pivot shift test; (3) at least –5° to 140° of knee excursion achieved postsurgically with no knee motion complications resulting in an arthroscopic release of contracted scar tissues or permanent loss of motion; (4) at least 2 years of serial arthrometer data and a patient follow-up; (5) no unusual rehabilitation
Questionnaire
The time of return to 5 activities (running, full-speed running, sports activities, unorganized sports, organized sports) is summarized in table 1. Although patients generally commenced running at 6 months postsurgery, 7 started running sooner than 6 months: 3 patients began running at 3 months, 2 patients at 4 months, and 2 patients at 5 months. The average start of full-speed running was around 11 months postoperatively; 1 patient started at 5 months, 9 patients started at 6 months, 1
Discussion
To our knowledge, this is the first study to use a follow-up questionnaire about the patients’ time of their return to activities (running, full-speed running, sport activity, unorganized sports, organized sports). A questionnaire was given to those patients who had an ACLR 24 to 36 months before their regular visit to our hospital, unless the patients were unsure about the time of their return to sports activities at more than 36 months after surgery. The results revealed that some patients
Conclusions
Our study showed that some patients are highly motivated for an early return to sports activity after their ACLR, and that these patients had poor ACL stability. Our results also indicated that the start of running, full-speed running, and sports activities could affect both the intermediate postsurgical stability and the 24-month stability. We concluded that an early return to vigorous activity is not recommended in ACLR using hamstring grafts.
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Cited by (22)
Graft Remodeling and Ligamentization after Anterior Cruciate Ligament Reconstruction
2018, The Anterior Cruciate Ligament: Reconstruction and Basic Science: Second EditionIntratunnel versus extratunnel fixation of hamstring autograft for anterior cruciate ligament reconstruction
2012, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :They advocated a return to “light” sports at 8 weeks after surgery. In contrast, Beynnon et al.,43 who studied patients after ACL reconstruction with BPTB autografts, and Fujimoto et al.,44 who studied patients after ACL reconstruction with hamstring autografts, have cautioned that early release to physical activity may increase knee laxity risk. When deciding on the timing of safe FWB timing, the knee surgeon is concerned with initial soft-tissue graft fixation.
Analysis of return to competition and repeat rupture for 298 anterior cruciate ligament reconstructions with patellar or hamstring tendon autograft in sportspeople
2010, Annals of Physical and Rehabilitation MedicineCitation Excerpt :Ainsi, ils ne retrouvent pas plus de laxité entre les dix patients, faisant un programme de rééducation accéléré après OTR, et les 12 patients, faisant une rééducation non accélérée, même si le faible nombre de participants diminue la puissance statistique du travail. En revanche, Fujimoto et al. [12], pour le DIDT, estiment qu’une reprise de la course trop rapide entraîne des laxités significatives, en faveur d’une détente de la plastie. De même, Heijne et Werner [16] ont montré l’augmentation de la laxité après travail sur chaise à quadriceps à quatre semaines de l’intervention pour les DIDT.
A prospective study of 3-day versus 2-week immobilization period after anterior cruciate ligament reconstruction
2007, KneeCitation Excerpt :However, the mean side-to-side differences of anterior laxity would become stable after 24 months' follow-up as well as previous reports [8,20]. Fujimoto et al. [21] reported the first serial arthrometer measurements of ACL reconstruction using hamstring tendons. At the 24-month follow-up evaluation, 37 patients (74%) had a functional reconstruction and normal displacement measurements.
Overview of anterior cruciate ligament rehabilitation and its evolution in Hong Kong in the past 8 years
2004, Hong Kong Physiotherapy JournalPediatric Revision Anterior Cruciate Ligament Reconstruction: Current Concepts Review
2022, Clinical Journal of Sport Medicine
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