SportLogia
Vol. 12, Issue 1, June 2016.

 

SPORT PARTICIPATION AFTER  INJURY OF ANTERIOR CRUCIATE LIGAMENT


Bojan Ilić1, Aleksandra Nikolić2 and Dejan Ilić3
1,,Ruđer Bošković“ Education Centre, Belgrade, Republic of Serbia
2 Faculty of Sport and Physical Education, Belgrade, Republic of Serbia
3 Faculty of Sport and Physical Education, Belgrade, Republic of Serbia


Professional paper
doi:10.5550/sgia.161201.en.INI
UDC: 796.41: 615.83
COBISS.BH-ID: 6765080

 

Summary

One of the most common problems involving the knee joint is an anterior cruciate ligament injury or ACL tear. Of the four major knee ligaments of the knee, an ACL injury or rupture is the most debilitating knee ligament injury. Ligament injuries in the knee joint often lead to premature end of sport career in athletes. Treatment following ACL rupture can be operative or conservative. In both cases, main goal of patient is to reach the best functional level, without risk of re-injury or degenerative changes in knee joint. Return to high level of sport performance is the indicator of successfull treatment. Rehabilitation represents crucial part of threatment. Knowledge on healing processes and knee biomechanics after injury and recostruction, along with physiologial aspects of training processess, is very importmant for the construction of training programs. Current rehabilitation programs use immediate trainings, i.e. exercises for the increasement of range of motion. In most cases, rehabilitation programs are being created relative to time which is needed for the returnment to certain sport activities. In this article, we would like to provide an overview of the current strategies for sport participation and rehabilitation after ACL injury. Operation, along with completed rehabilitation program, which is sport-specific, should lead to functional stability of knee joint.  Furthermore, adequate muscle strength and performance can be presented as main criterias for the returning to sport activities. Another factors, such as additional injuries, sociological and psychological barieres, can also influence the returnement to sport activities. Therefore, they should be considered durring rehabilitation process and evaluation of the treatment.



Key words:physiotherapy,recovery, injuries, sport medicine, rehabilitation

FULL TEXT (.pdf)


References

Beard, D.J., Dodd, C.A., Trundle, H.R. et al. (1994). Proprioception enhancement for anterior cruciate ligament deficiency: a prospective randomised trial of two physiotherapy regimes. J Bone Joint Surg Br, 76(4), 654–659.
            PMid:8027158
Berchuck, M., Andriacchi, T.P., Bach, B.R. et al. (1990). Gait adaptations by patients who have a deficient anterior cruciate ligament. J Bone Joint Surg Am, 72(6), 871–877.
            https://doi.org/10.2106/00004623-199072060-00012 [CrossRef]
PMid:2365720
Beynnon, B.D. & Johnson, R.J. (1996). Anterior cruciate ligament injury rehabilitation in athletes: biomechanical considerations. Sports Med, 22(1), 54–64.
            https://doi.org/10.2165/00007256-199622010-00005 [CrossRef]
PMid:8819240
Bjordal, J.M., Arnly, F., Hannestad, B. et al. (1997). Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med, 25(3), 341–345.
            https://doi.org/10.1177/036354659702500312 [CrossRef]
PMid:9167814
Bynum, E.B., Barrack, R.L. & Alexander, A.H. (1995). Open versus closed chain kinetic exercises after anterior cruciate ligament reconstruction: a prospective randomized study. Am J Sports Med, 23(4), 401–406.
            https://doi.org/10.1177/036354659502300405 [CrossRef]
PMid:7573647
Caraffa, A., Cerulli, G., Projetti, M. et al. (1996). Prevention of anterior cruciate ligament injuries in soccer: a prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc, 4(1), 19–21.
            https://doi.org/10.1007/BF01565992 [CrossRef]
PMid:8963746
Deehan, D.J., Salmon, L.J., Webb, V.J. et al. (2000). Endoscopic reconstruction of the anterior cruciate ligament with an ipsilateral patellar tendon autograft: a prospective longitudinal five-year study. J Bone Joint Surg Br, 82(7), 984–991.
            https://doi.org/10.1302/0301-620X.82B7.10573 [CrossRef]
PMid:11041586
Feller, J., Bartlett, J., Chapman, S., et al. (1997). Use of an extension-assisting brace following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 5(1), 6–9.
            https://doi.org/10.1007/s001670050016 [CrossRef]
PMid:9127846
Fitzgerald, G.K., Axe, M.J. & Snyder-Mackler, L. (2000). The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physical active individuals. Phys Ther, 80(2), 128–140.
            PMid:10654060
Friden, T., Roberts, D., Ageberg, E. et al. (2001). Review of knee proprioception and the relation to extremity function after an anterior cruciate ligament rupture. J Orthop Sports Phys Ther, 31(10), 567–576.
            https://doi.org/10.2519/jospt.2001.31.10.567 [CrossRef]
PMid:11665744
Fulkerson, J. & Hungerford, D. (1990). Normal anatomy. In Disordersof the Patellofemoral Joint. Baltimore, USA.
Gillquist, J. & Messner, K. (1999). Anterior cruciate ligament reconstruction and the long-term incidence of gonarthrosis. Sports Med, 27(3), 143–156.
            https://doi.org/10.2165/00007256-199927030-00001 [CrossRef]
PMid:10222538
Henriksson, M., Rockborn, P. & Good, L. (2002). Range of motion training in brace vs plaster immobilization after anterior cruciate ligament reconstruction: a prospective randomized comparison with a 2-year follow-up. Scand J Med Sci Sports, 12(2), 73–80.
            https://doi.org/10.1034/j.1600-0838.2002.120203.x [CrossRef]
PMid:12121424
Hewett, T.E., Lindenfeld, T.N., Riccobene, J.V. et al. (1999). The effect of neuromuscular training on the incidence of knee injury in female athletes: a prospective study. Am J Sports Med, 27(6), 699–706.
            PMid:10569353
Jansson, K.A., Linko, E., Sandelin, J. et al. (2003). A prospective randomized study of patellar versus hamstring tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med, 31(1), 12–18.
            PMid:12531751
Kartus, J., Stener, S., Kohler, K. et al. (1997). Is bracing after anterior cruciate ligament reconstruction necessary?: a 2-year follow-up of 78 consecutive patients rehabilitated with or without a brace. Knee Surg Sports Traumatol Arthrosc, 5(3), 157–161.
            https://doi.org/10.1007/s001670050044 [CrossRef]
PMid:9335027
Keays, S.L., Bullock-Saxton, J.E., Newcombe, P. et al. (2003). The relationship between knee strength and functional stability before and after anterior cruciate ligament reconstruction. J Orthop Res,21(2), 231–237.
            https://doi.org/10.1016/S0736-0266(02)00160-2 [CrossRef]
Kvist, J. & Gillquist, J. (2001). Anterior positioning of tibia during motion after anterior cruciate ligament injury. Med Sci Sports Exerc, 33(7), 1063–1072.
            https://doi.org/10.1097/00005768-200107000-00001 [CrossRef]
PMid:11445751
Markatos, K., Kaseta, M.K., Lallos, S.N., Korres, D.S. & Efstathopoulos, N. (2013). The anatomy of the ACL and its importance in ACL reconstruction. Eur J Orthop Surg Traumatol., 23(7), 747-752.
            https://doi.org/10.1007/s00590-012-1079-8 [CrossRef]
PMid:23412211
Mikkelsen, C., Werner, S. & Eriksson, E. (2000). Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc, 8(6), 337–342.
            https://doi.org/10.1007/s001670000143 [CrossRef]
PMid:11147151
Micheo, W., Hernandez, L. & Seda, C. (2010). Evaluation, management, rehabilitation, and prevention of anterior cruciate ligament injury: current concepts. PM R., 2(10), 935-944.
            https://doi.org/10.1016/j.pmrj.2010.06.014 [CrossRef]
PMid:20970763
Möller, E., Forssblad, M., Hansson, L. et al. (2001). Bracing versus nonbracing in rehabilitation after anterior cruciate ligament reconstruction: a randomized prospective study with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc, 9(2), 102–108.
            https://doi.org/10.1007/s001670000192 [CrossRef]
PMid:11354851
Morrey, M.A., Stuart, M.J., Smith, A.M. et al. (1999). A longitudinal examination of athletes’ emotional and cognitive responses to anterior cruciate ligament injury. Clin J Sport Med, 9(2), 63–69.
            https://doi.org/10.1097/00042752-199904000-00004 [CrossRef]
PMid:10442619
Morrissey, M.C., Hudson, Z.L., Drechsler, W.I. et al. (2000). Effects of open versus closed kinetic chain training on knee laxity in the early period after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 8(6), 343–348.
            https://doi.org/10.1007/s001670000161 [CrossRef]
PMid:11147152
Muellner, T., Alacamlioglu, Y., Nikolic, A. et al. (1998). No benefit of bracing on the early outcome after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 6(2), 88–92.
            https://doi.org/10.1007/s001670050078 [CrossRef]
PMid:9604192
Myklebust, G., Maehlum, S., Engebretsen, L. et al. (1997). Registration of cruciate ligament injuries in Norwegian top level team handball: a prospective study covering two seasons. Scand J Med Sci Sports, 7(5), 289–292.
            https://doi.org/10.1111/j.1600-0838.1997.tb00155.x [CrossRef]
PMid:9338947
Nielsen, A.B. & Yde, J. (1991). Epidemiology of acute knee injuries: a prospective hospital investigation. J Trauma, 31(12), 1644–1648.
            https://doi.org/10.1097/00005373-199112000-00014 [Crossref]
PMid:1749037
Ninković S. (2011). Uvećanje koštanog kanala u butnoj kosti i golenjači nakon rekonstrukcije prednjeg ukrštenog ligamenta kolena. Doktroska disertacija, Univerzitet u Novom Sadu, Medicinski fakultet Novi Sad.
Norwood, L. & Cross, M.  (1979). Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities. Am J Sports Med., (7), 23-26.
            https://doi.org/10.1177/036354657900700106 [Crossref]
PMid:420384
Osteras, H., Augestad, L.B. & Tondel, S. (1998). Isokinetic muscle strength after anterior cruciate ligament reconstruction. Scand J Med Sci Sport, 8 (5), 279–282.
            https://doi.org/10.1111/j.1600-0838.1998.tb00483.x [CrossRef]
Palmitier, R.A., An, K.N., Scott, S.G. et al. (1991). Kinetic chain exercise in knee rehabilitation. Sports Med, 11(6), 402–413.
            https://doi.org/10.2165/00007256-199111060-00005 [CrossRef]
PMid:1925185
Panni, A.S., Milano, G., Tartarone, M. et al. (2001). Clinical and radiographic results of ACL reconstruction: a 5- to 7-year follow-up study of outside-in versus inside-out reconstruction techniques. Knee Surg Sports Traumatol Arthrosc; 9(2), 77–85.
            https://doi.org/10.1007/s001670000171 [CrossRef]
PMid:11354857
Pinczewski, L.A., Deehan, D.J., Salmon, L.J. et al. (2002). A five-year comparison of patellar tendon versus four-strand hamstring tendon autograft for arthroscopic reconstruction of the anterior cruciate ligament. Am J Sports Med, 30(4), 523–536.
            PMid:12130407
Risberg, M.A., Holm, I., Steen, H. et al. (1999a). The effect of knee bracing after anterior cruciate ligament reconstruction: a prospective, randomized study with two years’ follow-up. Am J Sports Med, 27(1), 76–83.
            PMid:9934423
Risberg, M.A., Holm, I., Tjomsland, O. et al. (1999b). Prospective study of changes in impairments and disabilities after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther, 29(7), 400–412.
            https://doi.org/10.2519/jospt.1999.29.7.400 [CrossRef]
PMid:10416180
Risberg, M.A., Mork, M., Jenssen, H.K. et al. (2001). Design and implementation of a neuromuscular training program following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther., 31(11), 620–631.
            https://doi.org/10.2519/jospt.2001.31.11.620 [CrossRef]
PMid:11720295
Roos, H., Ornell, M., Gardsell, P. et al. (1995). Soccer after anterior cruciate ligament injury: an incompatible combination?: a national survey of incidence and risk factors and a 7-year follow-up of 310 players. Acta Orthop Scand, 66(2), 107–112.
            https://doi.org/10.3109/17453679508995501 [CrossRef]
PMid:7740937
Ross, M.D., Irrgang, J.J., Denegar, C.R. et al. (2002). The relationship between participation restrictions and selected clinical measures following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 10(1), 10–19.
            https://doi.org/10.1007/s001670100238 [CrossRef]
PMid:11819015
Shelbourne, K.D. & Davis, T.J. (1999). Evaluation of knee stability before and after participation in a functional sports agility program during rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med, 27(2), 156–161.
            PMid:10102094
Shelbourne, K.D. & Nitz, P. (1990). Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med., 18(3), 292–299.
            https://doi.org/10.1177/036354659001800313 [CrossRef]
PMid:2372081
Tyler, T., McHugh, M., Gleim, G. et al. (1998). The effect of immediate weightbearing after anterior cruciate ligament reconstruction. Clin Orthop., (357), 141–148.
            https://doi.org/10.1097/00003086-199812000-00019 [CrossRef]
Webb, J.M., Corry, I.S., Clingeleffer, A.J. et al. (1998). Endoscopic reconstruction for isolated anterior cruciate ligament rupture. J Bone Joint Surg Br., 80(2), 288–294.
            https://doi.org/10.1302/0301-620X.80B2.7994 [CrossRef]
PMid:9546463

Received: 04.05.2017.
Accepted: 26.06.2017.

Correspondence author:
Dejan Ilić, PhD
Faculty of Sport and Physical Education
University of Belgrade
Blagoja Parovića 156
11030 Belgrade
Serbia
Tel:+381(11)3531-000
dejan.ilic@fsfv.bg.ac.rs