| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Sign In to gain access to subscriptions and/or personal tools.
|
|
|
|||||||
Sign In to gain access to subscriptions and/or personal tools. |
|||||||||
Division of Orthopaedics, University Hospital, London, Ontario, Canada
Division of Orthopaedics, University Hospital, London, Ontario, Canada
Division of Orthopaedics, University Hospital, London, Ontario, Canada
Limitation of motion following ACL reconstruction is a well-recognized and disturbing complication. The pur poses of this study were to identify and characterize those patients who developed this complication from a series of 527 ACL reconstructions, determine etiologic factors, and make recommendations regarding preven tion and management.
The case group included 37 patients who required a manipulation under anesthesia because of failure to gain a satisfactory range of motion after an ACL recon struction. Unsatisfactory motion was defined as a flex ion deformity of 10° or more and/or limitation of flexion to less than 120° by 3 months following ACL recon struction. The control group of patients were selected randomly from the overall series and all had a satisfac tory range of motion.
The cases and controls were then compared by analyzing these variables: age, sex, knee, time from injury to reconstruction, type of tissue used, meniscal abnormalities or surgery, repair of the medial collateral ligament, and postoperative immobilization and rehabil itation. The cases were followed up to assess the range of motion compared to the opposite knee at an average of 26 months postmanipulation.
Thirty-seven patients (7%) underwent a manipulation under anesthesia, 9 of these (24.3%) also had an arthroscopic arthrolysis. Reconstructions done less than 2 weeks postinjury showed a statistically signifi cant higher rate of knee stiffness. The same trend was also present for those reconstructed 2 to 6 weeks postinjury. All other variables failed to show a significant statistical difference. At followup, the average loss of extension was 4° and loss of flexion 5°.
The authors suggest that it is prudent to avoid im mediate reconstructive surgery. The stiff knee requires early aggressive management with a manipulation and or arthroscopic arthrolysis.
This article has been cited by other articles:
|
|
 |
|
  J. O. Drogset, T. Grontvedt, O. R. Robak, A. Molster, A. T. Viset, and L. Engebretsen A Sixteen-Year Follow-up of Three Operative Techniques for the Treatment of Acute Ruptures of the Anterior Cruciate Ligament J. Bone Joint Surg. Am., May 1, 2006; 88(5): 944 - 952. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Beynnon, R. J. Johnson, J. A. Abate, B. C. Fleming, and C. E. Nichols Treatment of Anterior Cruciate Ligament Injuries, Part I Am. J. Sports Med., October 1, 2005; 33(10): 1579 - 1602. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Grant, N. G. H. Mohtadi, M. E. Maitland, and R. F. Zernicke Comparison of Home Versus Physical Therapy-Supervised Rehabilitation Programs After Anterior Cruciate Ligament Reconstruction: A Randomized Clinical Trial Am. J. Sports Med., September 1, 2005; 33(9): 1288 - 1297. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G.-S. Huang, C.-H. Lee, W. P. Chan, H.-S. Lee, C.-Y. Chen, and J. S. Yu Acute Anterior Cruciate Ligament Stump Entrapment in Anterior Cruciate Ligament Tears: MR Imaging Appearance Radiology, November 1, 2002; 225(2): 537 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Marx, T. J. Stump, E. C. Jones, T. L. Wickiewicz, and R. F. Warren Development and Evaluation of an Activity Rating Scale for Disorders of the Knee Am. J. Sports Med., March 1, 2001; 29(2): 213 - 218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kartus, L. Ejerhed, N. Sernert, S. Brandsson, and J. Karlsson Comparison of Traditional and Subcutaneous Patellar Tendon Harvest: A Prospective Study of Donor Site-Related Problems After Anterior Cruciate Ligament Reconstruction Using Different Graft Harvesting Techniques Am. J. Sports Med., May 1, 2000; 28(3): 328 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. R. Bach Jr, M. E. Levy, J. Bojchuk, S. Tradonsky, C. A. Bush-Joseph, and N. H. Khan Single-Incision Endoscopic Anterior Cruciate Ligament Reconstruction Using Patellar Tendon Autograft: Minimum Two-Year Follow-Up Evaluation Am. J. Sports Med., January 1, 1998; 26(1): 30 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. FRANK and D. W. JACKSON Current Concepts Review - The Science of Reconstruction of the Anterior Cruciate Ligament J. Bone Joint Surg. Am., October 1, 1997; 79(10): 1556 - 76. [Full Text]
|
|
|
|
|
|
K. D. Shelbourne and R. V. Trumper Preventing Anterior Knee Pain After Anterior Cruciate Ligament Reconstruction Am. J. Sports Med., January 1, 1997; 25(1): 41 - 47. [Abstract] [PDF]
|
|
|
|
|
|
T. Muneta, Y. Ezura, I. Sekiya, and H. Yamamoto Anterior Knee Laxity and Loss of Extension After Anterior Cruciate Ligament Injury Am. J. Sports Med., September 1, 1996; 24(5): 603 - 607. [Abstract] [PDF]
|
|
|
|
|
|
T. GRØNTVEDT, L. ENGEBRETSEN, P. BENUM, O. FASTING, A. MØLSTER, and T. STRAND A Prospective, Randomized Study of Three Operations for Acute Rupture of the Anterior Cruciate Ligament. Five-Year Follow-up of One Hundred and Thirty-one Patients J. Bone Joint Surg. Am., February 1, 1996; 78(2): 159 - 69. [Abstract] [Full Text]
|
|
|
|
|
|
D. HILLARD-SEMBELL, D. M. DANIEL, M. L. STONE, B. E. DOBSON, and D. C. FITHIAN Combined Injuries of the Anterior Cruciate and Medial Collateral Ligaments of the Knee. Effect of Treatment on Stability and Function of the Joint J. Bone Joint Surg. Am., February 1, 1996; 78(2): 169 - 76. [Abstract] [Full Text]
|
|
|
|
|
|
K. D. Shelbourne and D. A. Foulk Timing of Surgery in Acute Anterior Cruciate Ligament Tears on the Return of Quadriceps Muscle Strength After Reconstruction Using an Autogenous Patellar Tendon Graft Am. J. Sports Med., December 1, 1995; 23(6): 686 - 689. [Abstract] [PDF]
|
|
|
|
|
|
M. Marcacci, S. Zaffagnini, F. Iacono, M. Pia Neri, and A. Petitto Early Versus Late Reconstruction for Anterior Cruciate Ligament Rupture: Results After Five Years of Followup Am. J. Sports Med., December 1, 1995; 23(6): 690 - 693. [Abstract] [PDF]
|
|
|
|
|
|
R. A. Rubinstein JR, K. D. Shelbourne, C. D. VanMeter, J. R. McCarroll, A. C. Rettig, and R. L. Gloyeske Effect on Knee Stability if Full Hyperextension is Restored Immediately After Autogenous Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction Am. J. Sports Med., June 1, 1995; 23(3): 365 - 368. [Abstract] [PDF]
|
|
|
|
|
|
B. R. Bach JR, G. T. Jones, F. A. Sweet, and C. A. Hager Arthroscopy-assisted Anterior Cruciate Ligament Reconstruction Using Patellar Tendon Substitution: Two- to Four-year Follow-up Results Am. J. Sports Med., December 1, 1994; 22(6): 758 - 767. [Abstract] [PDF]
|
|
|
|
|
|
L. E. Paulos, D. C. Wnorowski, and A. E. Greenwald Infrapatellar Contracture Syndrome: Diagnosis, Treatment, and Long-Term Followup Am. J. Sports Med., July 1, 1994; 22(4): 440 - 449. [Abstract] [PDF]
|
|
|
|
|
|
R. A. Rubinstein JR, K. D. Shelbourne, C. D. VanMeter, J. C. McCarroll, and A. C. Rettig Isolated Autogenous Bone-Patellar Tendon-Bone Graft Site Morbidity Am. J. Sports Med., June 1, 1994; 22(3): 324 - 327. [Abstract] [PDF]
|
|
|
|
|
|
S. E. Fisher and K. D. Shelbourne Arthroscopic treatment of symptomatic extension block complicating anterior cruciate ligament reconstruction Am. J. Sports Med., July 1, 1993; 21(4): 558 - 564. [Abstract] [PDF]
|
|
| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
