| 1. |
- Figueroa, D., et al.
(author)
-
Return to sport soccer after anterior cruciate ligament reconstruction: ISAKOS consensus
- 2022
-
In: Journal of ISAKOS. - : Elsevier BV. - 2059-7754. ; 7:6, s. 150-161
-
Journal article (peer-reviewed)abstract
- Introduction: Many factors can affect the return to pivoting sports, after an Anterior Cruciate Ligament Reconstruction. Prehabilitation, rehabilitation, surgical and psychological aspects play an essential role in the decision to return to sports. The purpose of this study is to reach an international consensus about the best conditions for returning to sports in soccer—one of the most demanding level I pivoting sports after anterior cruciate ligament (ACL) reconstruction. Methods: 34 International experts in the management of ACL injuries, representing all the Continents were convened and participated in a process based on the Delphi method to achieve a consensus. 37 statements related to ACL reconstruction were reviewed by the experts in three rounds of surveys in complete anonymity. The statements were prepared by the working group based on previous literature or systematic reviews. Rating agreement through a Likert Scale: strongly agree, agree, neither agree or disagree, disagree and strongly disagree was used. To define consensus, it was established that the assertions should achieve a 75% of agreement or disagreement. Results: Of the 37 statements, 10 achieved unanimous consensus, 18 non-unanimous consensus and 9 did not achieve consensus. In the preoperative, the correction of the range of motion deficit, the previous high level of participation in sports and a better knowledge of the injury by the patient and compliance to participate in Rehabilitation were the statements that reached unanimous consensus. During the surgery, the treatment of associated injuries, as well as the use of autografts, and the addition of a lateral extra-articular tenodesis in some particular cases (active young athletes, <25 years old, hyperlaxity, high rotatory laxity and revision cases) obtained also 100% consensus. In the postoperative period, psychological readiness and its validation with scales, adequate physical preparation, as well as not basing the RTSS purely on the time of evolution after surgery, were the factors that reached unanimous Consensus. Conclusions: The consensus statements derived from this international ISAKOS leaders, may assist clinicians in deciding when to return to sports soccer in patients after an ACL reconstruction. Those statements that reached 100% consensus have to be strongly considered in the final decision to RTS soccer. © 2022 The Authors
|
|
| 2. |
- Pereira, H., et al.
(author)
-
Integration of polyurethane meniscus scaffold during ACL revision is not reliable at 5 years despite favourable clinical outcome
- 2022
-
In: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 30:10, s. 3422-3427
-
Journal article (peer-reviewed)abstract
- Purpose The aim of this study was to evaluate the clinical outcome at 5-year follow-up of a one-step procedure combining anterior cruciate ligament (ACL) reconstruction and partial meniscus replacement using a polyurethane scaffold for the treatment of symptomatic patients with previously failed ACL reconstruction and partial medial meniscectomy. Moreover, the implanted scaffolds have been evaluated by MRI protocol in terms of morphology, volume, and signal intensity. Methods Twenty patients with symptomatic knee laxity after failed ACL reconstruction and partial medial meniscectomy underwent ACL revision combined with polyurethane-based meniscal scaffold implant. Clinical assessment at 2- and 5-year follow-ups included VAS, Tegner Activity Score, International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lysholm Score. MRI evaluation of the scaffold was performed according to the Genovese scale with quantification of the scaffold's volume at 1- and 5-year follow-ups. Results All scores revealed clinical improvement as compared with the preoperative values at the 2- and 5-year follow-ups. However, a slight, but significant reduction of scores was observed between 2 and 5 years. Concerning the MRI assessment, a significant reduction of the scaffold's volume was observed between 1 and 5 years. Genovese Morphology classification at 5 years included two complete resorptions (Type 3) and all the remaining patients had irregular morphology (Type 2). With regard to the Genovese Signal at the 5-year follow-up, three were classified as markedly hyperintense (Type 1), 15 as slightly hyperintense (Type 2), and two as isointense (Type 1). Conclusion Simultaneous ACL reconstruction and partial meniscus replacement using a polyurethane scaffold provides favourable clinical outcomes in the treatment of symptomatic patients with previously failed ACL reconstruction and partial medial meniscectomy at 5 years. However, MRI evaluation suggests that integration of the scaffold is not consistent.
|
|
| 3. |
- Lindblom, Hanna, et al.
(author)
-
The knee control prevention programme
- 2018
-
In: Return to Play in Football : An Evidence-based Approach - An Evidence-based Approach. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 9783662557129 - 9783662557136 ; , s. 919-928
-
Book chapter (peer-reviewed)abstract
- In 2008, the Swedish Football Association and the insurance company Folksam, where all licensed players are insured, initiated a project aiming to reduce the burden of severe knee injuries in Swedish football. As a first step, the efficacy of an injury prevention exercise programme (IPEP) was evaluated in girls’ adolescent football (12–17 years). In a large-scale cluster randomised controlled trial including more than 4500 players, the Knee Control programme, a simple low-cost IPEP that takes no more than 10–15 min to complete, was found to reduce the rate of anterior cruciate ligament injury by 64%. Compliance with the IPEP is key, with large injury rate reductions seen in the most diligent players, whereas in players who only used the programme sporadically, it had no preventive effect. In this chapter some of the experiences from the Knee Control injury prevention initiative are summarised, including the evaluation of the programme’s preventive efficacy, performance effects and the implementation efforts made in Swedish football.
|
|
| 4. |
- Pereira, B. S., et al.
(author)
-
Current Concepts on Subtalar Instability
- 2021
-
In: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 9:8
-
Journal article (peer-reviewed)abstract
- Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conservative or surgical treatment and result in chronic ankle instability. Understanding the accurate anatomy and biomechanics of the subtalar joint, their interplay, and the contributions of the different subtalar soft tissue structures is fundamental to correctly diagnose and manage subtalar instability. An accurate diagnosis is crucial to correctly identify those patients with instability who may require conservative or surgical treatment. Many different nonsurgical and surgical approaches have been proposed to manage combined or isolated subtalar instability, and the clinician should be aware of available treatment options to make an informed decision. In this current concepts narrative review, we provide a comprehensive overview of the current knowledge on the anatomy, biomechanics, clinical and imaging diagnosis, nonsurgical and surgical treatment options, and outcomes after subtalar instability treatment.
|
|
