A Retrospective ACL Rehabilitation Outcomes Analysis Los Gatos Orthopedic Sports Therapy Jesse R. Modica, SPT, MS Regis University Ross M. Nakaji, PT, OCS, SCS, ATC, CSCS Matthew W. Thompson, PT, DPT, CSCS
Addressing proximal strength preserves normal lower chain biomechanics…
A recent study on hip kinematics with cutting movements supports the premise that reduced sagital plane movement and excessive transverse plane movement during the initial phase of cutting may influence loading at the knee joint.
(Pollard, Sigward, & Powers; 2007)
In-season injury prevention program leads to significantly reduced excessive hip internal rotation and greater peak hip abduction during a functional jump-landing task.
Reliability: Excellent (0.95 ICC) compared to Cincinnati (0.88 ICC) which demonstrated greater variability. However, Cincinnati is also a reasonable outcome tool. (Marx et al., 2001)
Validity: The Lysholm, Cincinnati, Activities of Daily Living and American Academy of Orthopedic Surgeons Knee Scores all demonstrated acceptable face and content validity in a study of athletes. (Marx et al., 2001)
Minimum Detectable Change (MDC): “A documented change in Lysholm Knee Score <10 points may be attributable to measurement error” (Briggs et al., 2006)
Translation: Changes >10 points can be attributed to clinical improvement
Briggs, Kocher, Rodkey, & Steadman. Reliability, Validity, and Responsiveness of the Lysholm Knee Score and Tegner Activity Scale for Patients with Meniscal Injury of the Knee. Journal of Bone and Joint Surgery. 2006: 88(4); 698-705.
Bullock-Saxton, JE; Local Sensation Changes and Altered Hip Muscle Function Following Severe Ankle Sprain. Physical Therapy, 1994: 74 (1); 17-34.
Gauffin H, Tropp H; Altered Movements and Muscular Activation Patterns During the One Legged Jump in Patients with an Old ACL Rupture. American Journal of Sports Medicine. 1994: 20 (2); 182-192
Gobbi and Francisco. Factors Affecting Return to Sports After Anterior Cruciate Ligament Reconstruction with Patellar Tendon and Hamstring Graft: A Prospective Clinical Investigation. Knee Surgery Sports Traumatology and Arthroscopy . 2006: 14; 1021-1028.
Marx RG, Jones EC, Allen AA, Altchek DW, et al. Reliability, Validity, and Responsiveness to Change of Four Knee Outcome Scales for Athletic Patients. Journal of Bone and Joint Surgery. 2001: 83(10); 1459-1469.
Nicholas, J et. al., A Study of Thigh Muscle Weakness in Different Pathological States of the Lower Extremity. American Journal of Sports Medicine. 1976: 4(6); 241-248.
Pollard CD, Sigward SM, Ota S, Langford K, & Powers CM. The Influence of In-season Injury Prevention Training on Lower Extremity Kinematics During Landing in Female Soccer Players. Clinical Journal of Sports Medicine. 2006: 16(3); 223-227.
Pollard CD, Sigward SM, & Powers CM. Gender Differences in Hip Joint Kinematics and Kinetics During Side-step Cutting Maneuver. Clinical Journal of Sports Medicine . 2007: 17(1); 38-42.
Siebold R, Buelow JU, Bos L, Ellerman A. Primary ACL Reconstruction with Fresh Frozen Patellar versus Achilles’ Tendon Allografts. Archives of Orthopedic Trauma Surgery . 2003: 123; 180-185
Tegner Y, Lysholm J. Rating systems in the Evaluation of Knee Ligament Injuries. Clinical Orthopedics and Related Research . 1985; 43-49.