ACL Rehabilitation AND Return to play...2016/07/09 · ACL REHABILITATION AND RETURN TO PLAY BY...
Transcript of ACL Rehabilitation AND Return to play...2016/07/09 · ACL REHABILITATION AND RETURN TO PLAY BY...
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ACL REHABILITATION AND RETURN TO PLAY
BY
EDDY L ECHOLS, JR., MD.
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DEFINE RETURN TO PLAY
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EXPECTATIONS AND REALITY OF RETURN TO PLAY
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Arden CL, Webster KF, Taylor NF, Feller JA:
Return to sport following Anterior Cruciate Ligament
Reconstruction surgery: A systematic review and meta-
Analysis of the state of play. Br J Sports Med 2011;45(7):596-606.
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FACTORS THAT AFFECT RETURN TO PLAY
• Physiologic
• Psychologic
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Psychologic Impact on Return to Play( The Fear of Re-injury)
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PSYOLOGIC FACTORS THAT AFFECT RETURN TO PLAY
• Pre-operative
• Intra-operative
• Post operative
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PRE-OPERATIVE
• Inflammation/Pain
• Swelling
• Range of Motion
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EFFECT ON RETURN TO PLAY
• Stiffness/ Arthrofibrosis( Pre-op Range of Motion best predictor of Post-op)
• Increased Patello-Femoral Contact
• Pain and Altered Gait
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INTRA-OPERATIVE FACTORS
• Tunnel Placement
• Graft Choice
• Graft Fixation
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GRAFT CHOICE
• Autograft
• Allograft
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AUTOGRAFTS
• BTB
• Hamstring
• Quadriceps
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GRAFT FIXATION
• Aperture fixation ( Various Techniques)
• Suspensory Fixation
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POST OPERATIVE FACTORS
• Rehab
• Rehab
• Rehab
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Casio et al.”Return to Play after Anterior Cruciate Ligament
Reconstruction.”Clin Sports Med.2004; 23(3), 395-408.
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Shelbourne KD, Nitz P: Accelerated Rehabilitation
after Anterior Cruciate Ligament Reconstruction.
J Orthop Sports Phys Ther 1992;15(6):256-264.
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• Beynnan BD, Uh BS, Johnson RJ,et al: Rehabilitation after Anterior Cruciate Ligament reconstruction: A prospective randomized, double blind comparison of programs administered over two different time intervals. Am J Sports Med 2005;33(3): 347-359.
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THANK YOU