| Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. | |
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MedLine Citation:
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PMID: 23032584 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Rigorous rehabilitation after anterior cruciate ligament (ACL) reconstruction is necessary for a successful surgical outcome. A large number of clinical trials continue to assess aspects of this rehabilitation process. Prior systematic reviews evaluated fifty-four Level-I and II clinical trials published through 2005. METHODS: Eighty-five articles from 2006 to 2010 were identified utilizing multiple search engines. Twenty-nine Level-I or II studies met inclusion criteria and were evaluated with use of the CONSORT (Consolidated Standards of Reporting Trials) criteria. Topics included in this review are postoperative bracing, accelerated strengthening, home-based rehabilitation, proprioception and neuromuscular training, and six miscellaneous topics investigated in single trials. RESULTS: Bracing following ACL reconstruction remains neither necessary nor beneficial and adds to the cost of the procedure. Early return to sports needs further research. Home-based rehabilitation can be successful. Although neuromuscular interventions are not likely to be harmful to patients, they are also not likely to yield large improvements in outcomes or help patients return to sports faster. Thus, they should not be performed to the exclusion of strengthening and range-of-motion exercises. Vibration training may lead to faster and more complete proprioceptive recovery but further evidence is needed. CONCLUSIONS: Several new modalities for rehabilitation after ACL reconstruction may be helpful but should not be performed to the exclusion of range-of-motion, strengthening, and functional exercises. Accelerated rehabilitation does not appear to be harmful but further investigation of rehabilitation timing is warranted. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. |
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Authors:
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L M Kruse; B Gray; R W Wright |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: The Journal of bone and joint surgery. American volume Volume: 94 ISSN: 1535-1386 ISO Abbreviation: J Bone Joint Surg Am Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-03 Completed Date: 2012-12-17 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0014030 Medline TA: J Bone Joint Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 1737-48 Citation Subset: AIM; IM |
Affiliation:
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Department of Orthopedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anterior Cruciate Ligament
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injuries*,
surgery Anterior Cruciate Ligament Reconstruction / methods, rehabilitation* Braces / utilization Exercise Therapy / methods* Female Follow-Up Studies Humans Knee Injuries / radiography, rehabilitation*, surgery Male Pain Measurement Postoperative Care / methods Randomized Controlled Trials as Topic Range of Motion, Articular / physiology* Recovery of Function Risk Assessment Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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