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- Henriksson, M, et al.
(författare)
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Range of motion training in brace vs. plaster immobilization after anterior cruciate ligament reconstruction : A prospective randomized comparison with a 2-year follow-up
- 2002
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - 0905-7188 .- 1600-0838. ; 12:2, s. 73-80
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this prospective and randomized study was to compare rehabilitation with early range of motion (ROM) training vs immobilization following anterior cruciate ligament (ACL) reconstruction. Fifty patients, undergoing an ACL reconstruction with a bone-patellar tendon-bone graft, were postoperatively allocated randomly to either a plaster cast or a brace for 5 weeks. The brace group had ROM exercises from post-operative day 7. The commencement of ROM exercises was postponed 4 weeks for the plaster group compared to the brace group, but progressed subsequently with equal speed. There was no difference between the groups in the ROM of flexion or extension 20 weeks after the ACL reconstruction and later. Twenty-four months after surgery, the muscle strength deficit in the hamstring muscles (isokinetic measurements, percent difference, injured vs uninjured) was significantly larger in the brace group (mean +/- SD: 5.9 +/- 7.8%, P < 0.01) than in the plaster group (-0.9 +/- 11.8%, NS) (brace vs plaster group, P <0.05). Furthermore, there was also a tendency in the brace group to a larger strength deficit in the quadriceps muscle (brace: 11.1 +/- 13.2%, P <0.001, plaster: 3.8 +/- 12.9%, NS) (brace vs plaster group, P = 0.07). There was no difference between the groups in the total sagittal knee laxity, as measured with an arthrometer, or in the subjective knee function or activity level (Lysholm score together with the Tegner activity level) between the groups. It is concluded that the postoperative treatment with early range of motion training after ACL reconstruction gave as good ROM, knee stability, subjective knee function and activity level as the treatment with immobilization. It is hypothesized that the larger strength deficit observed after rehabilitation with early range of motion training is secondary to the more intensive training and physical therapist involvement that was demanded in order to achieve full ROM following immobilization.
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- Rockborn, P., et al.
(författare)
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Arthroscopic meniscectomy : Treatment costs and postoperative function in a historical perspective
- 2000
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Ingår i: Acta Orthopaedica Scandinavica. - 0001-6470. ; 71:5, s. 455-460
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Tidskriftsartikel (refereegranskat)abstract
- We report short-term data from 82 consecutive patients with arthroscopic meniscectomy 1995-1998 in stable knees and without severe cartilage changes. All patients were treated as outpatients, the operating time was, on average, 23 SD12 minutes and 3 of 4 patients were back at work within 1 week. Almost half of the patients still had some knee problems 3 months after surgery, but thereafter a substantial improvement was seen. We also report original data from a consecutive series of patients having arthroscopic meniscectomy 1980-81. In that series, the frequency of total meniscectomies was higher, the operating time longer, but the time to recovery was shorter than in 1995-98. In contrast to 1995-98, most of the patients in 1980-81 were followed by the doctor and had supervised rehabilitation. However, sick leave was similar in the two series. The total costs for an arthroscopic meniscectomy in 1998 was less than half the costs in 1980-81. We conclude that the improved technique for arthroscopic meniscectomy during the last 15-20 years and less supervised rehabilitation have reduced the costs, but not the recovery time.
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