Knee pain after anterior cruciate ligament reconstruction: evaluation of a rehabilitation protocol
Introduction Anterior knee pain (AKP) is a rare and difficult complication following anterior cruciate ligament (ACL) reconstruction. This disabling pain is persistent with conventional rehabilitation protocols. The aim of this work is to validate a new rehabilitation protocol that may improve the p...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2014-07, Vol.24 (5), p.789-795 |
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| container_title | European journal of orthopaedic surgery & traumatology |
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| creator | Gadea, F. Monnot, D. Quélard, B. Mortati, R. Thaunat, M. Fayard, J. M. Sonnery-Cottet, B. |
| description | Introduction
Anterior knee pain (AKP) is a rare and difficult complication following anterior cruciate ligament (ACL) reconstruction. This disabling pain is persistent with conventional rehabilitation protocols. The aim of this work is to validate a new rehabilitation protocol that may improve the patients and allow return to daily activities including sports.
Materials and methods
Forty-three patients identified with functional AKP after ACL reconstruction was enrolled in the rehabilitation protocol between 2009 and 2011. The series included twenty-six patients with hamstring grafting and seventeen patients with patellar tendon transplant. This study compares the functional outcomes and pain scores before and after the isokinetic protocol until the last follow-up at an average of 25.7 months after surgery. The evaluation was performed according to the International Knee Documentation Committee (IKDC) and included a pain assessment using the visual analog scale. Statistical analysis used Student’s
t
-test for unpaired data and the Pearson correlation test for the variables. The IKDC scores were compared by the Wilcoxon test.
Results
Functional outcomes and pain are significantly improved (
p
|
| doi_str_mv | 10.1007/s00590-013-1248-4 |
| format | Article |
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Anterior knee pain (AKP) is a rare and difficult complication following anterior cruciate ligament (ACL) reconstruction. This disabling pain is persistent with conventional rehabilitation protocols. The aim of this work is to validate a new rehabilitation protocol that may improve the patients and allow return to daily activities including sports.
Materials and methods
Forty-three patients identified with functional AKP after ACL reconstruction was enrolled in the rehabilitation protocol between 2009 and 2011. The series included twenty-six patients with hamstring grafting and seventeen patients with patellar tendon transplant. This study compares the functional outcomes and pain scores before and after the isokinetic protocol until the last follow-up at an average of 25.7 months after surgery. The evaluation was performed according to the International Knee Documentation Committee (IKDC) and included a pain assessment using the visual analog scale. Statistical analysis used Student’s
t
-test for unpaired data and the Pearson correlation test for the variables. The IKDC scores were compared by the Wilcoxon test.
Results
Functional outcomes and pain are significantly improved (
p
< 0.0001). The average IKDC score improved with 28 points and the pain improved with 3.2 points on the visual analog scale (VAS). The results are correlated with the follow-up time (
p
= 0.008) but not correlated with the delay between the surgery and the beginning of the isokinetic protocol.
Discussion
Isokinetic rehabilitation provides a significant improvement in the knee function as measured by the IKDC score and by the VAS, regardless of the painful period preceding the program. The function improvement continues after the end of the protocol, but the pain may not completely disappear. The isokinetic rehabilitation program may resume functional AKP related to muscular deficit and may be used as the starter of other physical therapy protocols.
Level of evidence
IV.</description><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-013-1248-4</identifier><identifier>PMID: 23744093</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Adult ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction - adverse effects ; Anterior Cruciate Ligament Reconstruction - rehabilitation ; Arthralgia - etiology ; Arthralgia - rehabilitation ; Exercise Therapy - methods ; Humans ; Knee ; Knee Joint ; Male ; Medicine ; Medicine & Public Health ; Muscle Strength - physiology ; Muscle Strength Dynamometer ; Original Article ; Pain ; Pain, Postoperative - etiology ; Pain, Postoperative - rehabilitation ; Quadriceps Muscle - physiology ; Rehabilitation ; Retrospective Studies ; Surgical Orthopedics ; Traumatic Surgery</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2014-07, Vol.24 (5), p.789-795</ispartof><rights>Springer-Verlag France 2013</rights><rights>Springer-Verlag France 2013.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3204-5fa9f448fcb8650f9f08ddddde9b6a0b645e0d59fef4c13f324fe048e02431003</citedby><cites>FETCH-LOGICAL-c3204-5fa9f448fcb8650f9f08ddddde9b6a0b645e0d59fef4c13f324fe048e02431003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-013-1248-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-013-1248-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23744093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gadea, F.</creatorcontrib><creatorcontrib>Monnot, D.</creatorcontrib><creatorcontrib>Quélard, B.</creatorcontrib><creatorcontrib>Mortati, R.</creatorcontrib><creatorcontrib>Thaunat, M.</creatorcontrib><creatorcontrib>Fayard, J. M.</creatorcontrib><creatorcontrib>Sonnery-Cottet, B.</creatorcontrib><title>Knee pain after anterior cruciate ligament reconstruction: evaluation of a rehabilitation protocol</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Introduction
Anterior knee pain (AKP) is a rare and difficult complication following anterior cruciate ligament (ACL) reconstruction. This disabling pain is persistent with conventional rehabilitation protocols. The aim of this work is to validate a new rehabilitation protocol that may improve the patients and allow return to daily activities including sports.
Materials and methods
Forty-three patients identified with functional AKP after ACL reconstruction was enrolled in the rehabilitation protocol between 2009 and 2011. The series included twenty-six patients with hamstring grafting and seventeen patients with patellar tendon transplant. This study compares the functional outcomes and pain scores before and after the isokinetic protocol until the last follow-up at an average of 25.7 months after surgery. The evaluation was performed according to the International Knee Documentation Committee (IKDC) and included a pain assessment using the visual analog scale. Statistical analysis used Student’s
t
-test for unpaired data and the Pearson correlation test for the variables. The IKDC scores were compared by the Wilcoxon test.
Results
Functional outcomes and pain are significantly improved (
p
< 0.0001). The average IKDC score improved with 28 points and the pain improved with 3.2 points on the visual analog scale (VAS). The results are correlated with the follow-up time (
p
= 0.008) but not correlated with the delay between the surgery and the beginning of the isokinetic protocol.
Discussion
Isokinetic rehabilitation provides a significant improvement in the knee function as measured by the IKDC score and by the VAS, regardless of the painful period preceding the program. The function improvement continues after the end of the protocol, but the pain may not completely disappear. The isokinetic rehabilitation program may resume functional AKP related to muscular deficit and may be used as the starter of other physical therapy protocols.
Level of evidence
IV.</description><subject>Adult</subject><subject>Anterior Cruciate Ligament Injuries</subject><subject>Anterior Cruciate Ligament Reconstruction - adverse effects</subject><subject>Anterior Cruciate Ligament Reconstruction - rehabilitation</subject><subject>Arthralgia - etiology</subject><subject>Arthralgia - rehabilitation</subject><subject>Exercise Therapy - methods</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Muscle Strength - physiology</subject><subject>Muscle Strength Dynamometer</subject><subject>Original Article</subject><subject>Pain</subject><subject>Pain, Postoperative - etiology</subject><subject>Pain, Postoperative - rehabilitation</subject><subject>Quadriceps Muscle - physiology</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1LXTEQhkNR6kf7A7opATfdnDr5vCfdidhaFNzoOuTkTmzk3OQ2OUfw35vLsRUEs0iGmWfeCfMS8oXBdwawOq0AykAHTHSMy76TH8ghk4J3DHS_12ItRNeDVgfkqNYHAKYMUx_JARcrKcGIQzJcJUS6dTFRFyYs1KV2x1yoL7OPbkI6xnu3wTTRgj6nOrX8FHP6QfHRjbPbxTQH6lr9jxviGKclty15yj6Pn8h-cGPFzy_vMbn7eXF7ftld3_z6fX523XnBQXYqOBOk7IMfeq0gmAD9enfQDNrBoKVCWCsTMEjPRBBcBgTZI3Ap2jrEMfm26LbBf2esk93E6nEcXcI8V8uUMFJrYXRDT96gD3kuqf3O8l6sOGuCvFFsoXzJtRYMdlvixpUny8DuDLCLAbYZYHcGWNl6vr4oz8MG1_87_m28AXwBaiuleyyvo99XfQbppZFm</recordid><startdate>201407</startdate><enddate>201407</enddate><creator>Gadea, F.</creator><creator>Monnot, D.</creator><creator>Quélard, B.</creator><creator>Mortati, R.</creator><creator>Thaunat, M.</creator><creator>Fayard, J. M.</creator><creator>Sonnery-Cottet, B.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>201407</creationdate><title>Knee pain after anterior cruciate ligament reconstruction: evaluation of a rehabilitation protocol</title><author>Gadea, F. ; Monnot, D. ; Quélard, B. ; Mortati, R. ; Thaunat, M. ; Fayard, J. M. ; Sonnery-Cottet, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3204-5fa9f448fcb8650f9f08ddddde9b6a0b645e0d59fef4c13f324fe048e02431003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Anterior Cruciate Ligament Injuries</topic><topic>Anterior Cruciate Ligament Reconstruction - adverse effects</topic><topic>Anterior Cruciate Ligament Reconstruction - rehabilitation</topic><topic>Arthralgia - etiology</topic><topic>Arthralgia - rehabilitation</topic><topic>Exercise Therapy - methods</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Muscle Strength - physiology</topic><topic>Muscle Strength Dynamometer</topic><topic>Original Article</topic><topic>Pain</topic><topic>Pain, Postoperative - etiology</topic><topic>Pain, Postoperative - rehabilitation</topic><topic>Quadriceps Muscle - physiology</topic><topic>Rehabilitation</topic><topic>Retrospective Studies</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gadea, F.</creatorcontrib><creatorcontrib>Monnot, D.</creatorcontrib><creatorcontrib>Quélard, B.</creatorcontrib><creatorcontrib>Mortati, R.</creatorcontrib><creatorcontrib>Thaunat, M.</creatorcontrib><creatorcontrib>Fayard, J. M.</creatorcontrib><creatorcontrib>Sonnery-Cottet, B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gadea, F.</au><au>Monnot, D.</au><au>Quélard, B.</au><au>Mortati, R.</au><au>Thaunat, M.</au><au>Fayard, J. M.</au><au>Sonnery-Cottet, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Knee pain after anterior cruciate ligament reconstruction: evaluation of a rehabilitation protocol</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2014-07</date><risdate>2014</risdate><volume>24</volume><issue>5</issue><spage>789</spage><epage>795</epage><pages>789-795</pages><issn>1633-8065</issn><eissn>1432-1068</eissn><abstract>Introduction
Anterior knee pain (AKP) is a rare and difficult complication following anterior cruciate ligament (ACL) reconstruction. This disabling pain is persistent with conventional rehabilitation protocols. The aim of this work is to validate a new rehabilitation protocol that may improve the patients and allow return to daily activities including sports.
Materials and methods
Forty-three patients identified with functional AKP after ACL reconstruction was enrolled in the rehabilitation protocol between 2009 and 2011. The series included twenty-six patients with hamstring grafting and seventeen patients with patellar tendon transplant. This study compares the functional outcomes and pain scores before and after the isokinetic protocol until the last follow-up at an average of 25.7 months after surgery. The evaluation was performed according to the International Knee Documentation Committee (IKDC) and included a pain assessment using the visual analog scale. Statistical analysis used Student’s
t
-test for unpaired data and the Pearson correlation test for the variables. The IKDC scores were compared by the Wilcoxon test.
Results
Functional outcomes and pain are significantly improved (
p
< 0.0001). The average IKDC score improved with 28 points and the pain improved with 3.2 points on the visual analog scale (VAS). The results are correlated with the follow-up time (
p
= 0.008) but not correlated with the delay between the surgery and the beginning of the isokinetic protocol.
Discussion
Isokinetic rehabilitation provides a significant improvement in the knee function as measured by the IKDC score and by the VAS, regardless of the painful period preceding the program. The function improvement continues after the end of the protocol, but the pain may not completely disappear. The isokinetic rehabilitation program may resume functional AKP related to muscular deficit and may be used as the starter of other physical therapy protocols.
Level of evidence
IV.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>23744093</pmid><doi>10.1007/s00590-013-1248-4</doi><tpages>7</tpages></addata></record> |
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| ispartof | European journal of orthopaedic surgery & traumatology, 2014-07, Vol.24 (5), p.789-795 |
| issn | 1633-8065 1432-1068 |
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| subjects | Adult Anterior Cruciate Ligament Injuries Anterior Cruciate Ligament Reconstruction - adverse effects Anterior Cruciate Ligament Reconstruction - rehabilitation Arthralgia - etiology Arthralgia - rehabilitation Exercise Therapy - methods Humans Knee Knee Joint Male Medicine Medicine & Public Health Muscle Strength - physiology Muscle Strength Dynamometer Original Article Pain Pain, Postoperative - etiology Pain, Postoperative - rehabilitation Quadriceps Muscle - physiology Rehabilitation Retrospective Studies Surgical Orthopedics Traumatic Surgery |
| title | Knee pain after anterior cruciate ligament reconstruction: evaluation of a rehabilitation protocol |
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