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Introduction: therapeutic equivalence has been established in the effectiveness of peripheral nerve blocks in the management of pain in the postoperative period of anterior cruciate ligament reconstruction. However, it is unknown whether this effect is modulated by the anesthesiologist’s experience. The objective was to describe the effectiveness of peripheral nerve blocks during the first 24 hours of the postoperative period, considering patient characteristics and the anesthesiologist’s experience. Material and methods: a retrospective cohort study was conducted from 2015 to 2017. Patients who received a femoral canal block, femoral nerve block, or spinal anesthesia were included. All data were obtained from the patient’s medical records, with pain assessed using a visual analog scale recorded in the medical records. A robust, non-parametric kernel regression model was generated to estimate the effect of the variables. Results: out of 480 clinical records, 168 were included in the analysis. The period of greatest pain was between eight and 12 hours, with a non-success rate of up to 22.9%. No differences were found between peripheral nerve blocks. The anesthesiologist’s experience did not influence the analgesic effect, while the use of a bone-tendon-bone graft determined greater postoperative pain. Conclusion: in minimally invasive procedures, good pain management outcomes could be observed independently of the anesthesiologist’s experience. [ABSTRACT FROM AUTHOR]

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Background: Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4 DSP) into Spanish. Methods: A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4 DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated. Results: The S-4DSP was fully completed by 108 participants (mean age 34 ± 10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively. Conclusions: The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction. Resumen: Antecedentes y objetivo: Las medidas de resultado reportadas por el paciente (PROM) son herramientas de interés creciente en la población deportiva. El propósito de este estudio fue realizar la adaptación transcultural y análisis de confiabilidad del 4-Domain Sports Patient-Reported Outcome Measure (4DSP) al español. Métodos: Se ejecutó un protocolo de adaptación transcultural en seis etapas para obtener la versión en español del 4DSP (S-4DSP). Posteriormente, se aplicó el cuestionario a una población de 108 deportistas posoperados de reconstrucción de ligamento cruzado anterior (RLCA). Se aplicó nuevamente el cuestionario luego de 30 días. Se evaluó la aceptabilidad, efecto piso y techo, consistencia interna (alfa de Cronbach) y reproducibilidad (correlación intraclase). Resultados: La S-4DSP fue respondida completamente por 108 participantes (edad media 34 ± 10,75, 26% mujeres) alcanzando una aceptabilidad de 100%. No se detectó efecto piso. El análisis estadístico entregó un alfa de Cronbach global para el cuestionario de 0,65, y desagregado por dominios de 0,88, 0,72, 0,27, 0,68 para el primer, segundo, tercer y cuarto dominio, respectivamente. El estudio de correlación intraclase alcanzó un máximo de 0,94 y un mínimo de 0,48 en la primera y quinta preguntas, respectivamente. Conclusión: El S-4DSP es una herramienta confiable y útil para evaluar deportistas de habla hispana posterior a una RLCA.

Introduction: anterior cruciate ligament injuries (ACL) continue increasing in frequency in the general population and sportmen who practice soccer and american football where we can locate 53% of the total of cases, the annual incidence is 70 per 100,000 persons. The incidence of this injuries has being increasing in women probably of the increase of the participation in such sports. Objective: to document the causes of anterior cruciate ligament (ACL) plasty failure, as well as the diagnosis, surgical technique, and postoperative care of a revision ACL plasty surgery. Material and methods: a search for relevant information, original research articles, clinical trials, and reviews in indexed journals was performed. Results: anterior cruciate ligament injuries continue to increase among the general population and athletes who play soccer and American soccer mainly, in this population group we found 53% of the total cases. The gold standard for treatment is arthroscopic reconstruction of the ligament. ACL reconstruction surgery has good results, with an estimated 75-90% success rate. Long-term failures of anterior cruciate ligament repair represent 5-25%. Among the factors associated with this failure are technical errors, traumatic antecedents, biological factors, among others. Conclusions: in ACL revision surgery good results can be achieved with respect to graft stability, return to play and functional stability of the knee, but the results are generally inferior to those of primary ACL reconstruction. [ABSTRACT FROM AUTHOR]

Copyright of Argentinian Journal of Respiratory & Physical Therapy (AJRPT) is the property of Asociacion Civil Cientifica de Difusion y Promocion de la Kinesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: la reconstrucción artroscópica del ligamento cruzado anterior (LCA) tiene un bajo índice de complicaciones postoperatorias. Cuando se presenta una infección en el postoperatorio inmediato, tanto el cirujano como el paciente se enfrentan a un escenario complejo y de difícil aceptación, que en algunos casos tiene consecuencias graves. En este contexto es importante conocer la incidencia reportada en la literatura para compararla con lo que ocurre en nuestras instituciones. El objetivo del presente trabajo es evaluar la incidencia de infección en una serie de casos consecutivos de reconstrucciones de LCA. Materiales y métodos: se realizó un estudio retrospectivo del período comprendido entre enero de 2015 y diciembre de 2017, donde se evaluó la incidencia de infección en una serie consecutiva de reconstrucciones de LCA. Fueron evaluados un total de setecientos catorce pacientes: seiscientos veintinueve masculinos y ochenta y cinco femeninos con un promedio de edad de veintiocho años (15-50). Resultados: de los setecientos catorce casos analizados, se encontraron seis infecciones postquirúrgicas (dos profundas y cuatro superficiales). Conclusiones: la incidencia de infección aguda postoperatoria luego de reconstrucción artroscópica del LCA fue del 0.84%, similar a lo reportado en la literatura. Se observó un franco predominio de infecciones en las reconstrucciones de LCA con injerto de isquiotibiales con respecto al resto de los injertos.

Las pruebas de salto (PS) son utilizadas con frecuencia como método de evaluación funcional en deportistas con lesiones de miembros inferiores. Actualmente, además de las PS convencionales, se propone incorporar PS verticales. Las mismas, pueden evaluarse mediante pruebas de laboratorio (plataforma de salto) o pruebas de campo (aplicación en smartphone o evaluación clínica). El objetivo de este paso a paso es describir dos pruebas de campo sencillas, confiables, de bajo costo, que se pueden utilizar en la práctica clínica en conjunto con otras pruebas para ayudar a los kinesiólogos a diseñar un programa de rehabilitación o progresión del tratamiento.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anterior Cruciate Ligament (ACL) rupture is one of the most common injuries in the current context, and reconstruction by autograft is the most used rehabilitation method along with physiotherapy for physical rehabilitation; However, certain biomechanical alterations have been detected in the gait pattern of these patients due to the effects that the injury produces on the surrounding structures and this has resulted in the development of degenerative pathologies secondary to the reconstruction of the ligament. The objective of the present investigation is to analyze the alterations in gait biomechanics present in patients with anterior cruciate ligament reconstruction through different autograft techniques. A systematic review was carried out based on the PRISMA method guidelines in the Google Scholar, PubMed, Scopus and Springerlink databases, including a total of 11 articles. Several gait alterations were detected in the patients analyzed in parameters such as angles of movement, joint range, tibial translation, moments of force and vertical ground reaction; being the knee flexion angle the most evaluated. However, the studies show discrepancies in several of the results found and, in addition, there is little or no information on the biomechanics of the hip and ankle; Therefore, it is difficult to reach a conclusion about a specific gait pattern for these patients. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To compare the clinical and functional outcomes of two different graft fixation methods, all-inside and anteromedial (AM), for single-bundle anterior cruciate ligament (ACL) reconstruction techniques. Methods: Comparing the mid-term results of two groups, the prospectively recorded data of patients diagnosed with isolated ACL rupture between 2015 and 2016 were reviewed retrospectively. Two groups of patients who underwent unilateral isolated ACL reconstruction via two different tibial fixation techniques (19 patients with all-inside [Group 1]; 20 patients with AM portal [Group 2]) from the same institution were enrolled as the study group. The patients were called for the final follow-up and evaluated for symptoms, knee stability (Lachman test, pivot shift test, and KT-1000 arthrometer analysis), and functional scores (Tegner and Lysholm knee scoring scale, International Knee Documentation Committee [IKDC] subjective knee score, and visual analog scale [VAS]). Results: The mean age and follow-up period were statistically equal between the two groups. The functional comparison of patients with Tegner and Lysholm knee and IKDC scores, showed no statistical difference at the mid-term follow-up period. In the clinical assessment of the operated knees, based on the Lachman test and KT-1000 arthrometer, the anterior translation results in group 1 were better than those in group 2, which was statistically significant. However, we obtained similar pivot shift test results in both groups. Conclusion: The study showed that ACL reconstruction via the all-inside had functionally better anterior translation and similar rotational stability results compared with the AM portal technique. Level of Evidence III, Case Control Study.

En muchos estudios se ha demostrado la utilidad del PRP en la disminución del dolor en la zona donante del tendón rotuliano utilizado como injerto, efecto antiinflamatorio y de reducción del dolor postoperatorio. En la actualidad en el estudio sobre ‘anestesia local intraarticular de la rodilla’ determinan varias técnicas utilizadas para la anestesia y analgesia de la cirugía artroscópica. Objetivo: Determinar la efectividad de la terapia biológica versus la bomba analgésica intraarticular en el manejo del dolor postoperatorio en la ACLR. Método: Longitudinal y prospectivo de campo con diseño de estudio experimental. Presentó una muestra de veintiocho pacientes, con diagnóstico de ruptura del LCA, que acudieron a la consulta de la unidad de rodilla y se subdividió en dos grupos de catorce pacientes con aplicación de tratamiento aleatorio, luego se aplicó la escala funcional de Lysholm y EVA para constatar el grado de dolor postoperatorio a las 24 horas y a la semana. Resultados: En cuanto a EVA, se evidencia un descenso en ambos grupos que fue corroborado a través de pruebas de hipótesis de diferencia de medias, donde los p-valores arrojados fueron significativos (p-valor: 0,0177 y 0,0062). Por el contrario, en la escala de Lysholm hubo un ascenso en el valor promedio posterior a la aplicación de terapia biológica y bomba analgésica (p-valor: 2,2E-08 y 1,3689E-08). Conclusión: La eficacia en ambos métodos fue similar en la evolución clínica, sin embargo, las diferencias estadísticas fue mayor a la semana de aplicado el tratamiento que en las primeras 24 horas.

Anterior cruciate ligament (ACL) rupture is a very important epidemiological pathology in our environment. It has a peak incidence between 16 to 39 years of age. It is estimated that between 70-84% of ACL injuries are non-contact. The «no return» position describes the knee in valgus, femoral external rotation, tibial internal rotation and semiflexion, promoting injury to this ligament. Geometric measurements of the knee have been associated with an increased probability of non-contact ACL injury. The management of ACL tears is divided into two: conservative treatment and surgical management. Early OA (osteoarthritis) is the most common consequence of an ACL tear. We present the case of a 35-year-old patient with an inveterate ACL rupture of 10 years of evolution. With conservative management initially that progresses to knee instability and pain in the medial and lateral joint line as well as increased volume and functional limitation. After diagnostic studies, it was decided to perform diagnostictherapeutic arthroscopy and continued close follow-up for associated pathology. [ABSTRACT FROM AUTHOR]

Copyright of Intercontinental Journal of Sport Management / Revista Intercontinental de Gestão Desportiva is the property of Revista Intercontinental de Gestao Desportiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anterior cruciate ligament (ACL) rupture is the most common knee injury to undergo surgery in the sports setting. The main objective of this review was to analyze the importance of hamstring function as a risk factor for potential ACL injury. It was conducted following the Preferred Reported Item for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The source of data collection was direct consultation of the Pubmed, Sportdiscus, Web of Science and Scopus databases. For documentary retrieval, several key words were used and the quality of the studies that were selected was assessed using the PEDro scale. Muscle function deficits in the hamstrings have been related to increased anterior tibial translation and, as a consequence, increased tensional stress on the ACL between 10° and 45° of knee flexion. A co-activation of the hamstrings with the quadriceps may be helpful in reducing the risk factors for ACL injury. [ABSTRACT FROM AUTHOR]

Introduction: Due to the inherent activities of the active duty personnel of the Mexican Navy, ligament injuries are constant, particularly the anterior cruciate ligament of the knee (ACL). Currently, we have various techniques and resources for its repair. Objective: identify the clinical results obtained in anterior cruciate ligament reconstruction in active military. Material and methods: retrospective observational study comparing clinical outcomes of anterior cruciate ligament repair in active military with the use of allograft and autograft in 23 patients who met inclusion criteria for the surgical procedure from 2017 to 2019 at the Naval Medical Center. 23 patients (46 in total) were considered for each category of anterior cruciate ligament repair with autologous graft (contralateral patellar) and heterologous graft (cadaveric anterior cruciate ligament). With an average age of autologous (35.6 years), heterologous (35 years). BMI average: autologous (26.5), heterologous (26.5). Male gender in its entirety. The IKDC and Lysholm scales were applied to all patients for the evolution of subjective results of clinical improvement in a 2-year follow-up; where a significant difference (p = 0.0001) could be observed when comparing both anterior cruciate ligament reconstruction techniques. Results: we included 46 patients who underwent anterior cruciate ligament reconstruction for indication of complete injury respectively by the Joint Surgery Service of the Naval Medical Center. A better level of clinical benefit was observed in patients with heterologous graft, both in evaluation by IKDC scale (median 95.52 ± 1.85) as in Lysholm scale (median 94.91 ± 1.62) compared to autologous grafts, IKDC (median 89.92 ± 2.55) and Lysholm (median 86.04 ± 5.58), with value of p = 0.0001 for both cases. Conclusions: The results our study suggests that a superiority of functionality is obtained as reported by patients in whom heterograft was used. [ABSTRACT FROM AUTHOR]

The anterior cruciate ligament (ACL) is a ligament that mainly controls the anterior and rotational mobility of the knee joint, and its surface is covered by a synovial membrane with large number of blood vessels. In general, nutritional supply to the ligament is from many capillaries in the adjacent synovium. However, statistical studies of the capillaries distributed to the ACL are insufficient. In this study, we examined cross-sectional histological images of the femoral attachment (femoral level), middle level of the tendon (middle level), and tibial attachment (tibial level) of the ACL and statistically analyzed blood capillary distribution among the three levels. The ACLs of 10 cadavers were divided into 5 equal sections, and 4mm-thick paraffin sections were made at the femoral level, middle level, and tibial level, and then hematoxylin-eosin (HE) staining were performed. The area of each transverse section was measured using Image-J 1.51n (U. S. National Institutes of Health, Bethesda, MD, USA). Fiber bundles of the ACL were relatively small and sparse in cross-sectional area at the femoral level and became larger and denser toward the tibial level. Many blood levels. The synovium at the attachment of ACL covered the surface of the fiber bundle and also penetrated deeply between the fiber bundles. In particular, the blood capillaries were densely distributed in the synovium at the femoral attachment rather than another two levels. Indeed, the number of capillaries were also most abundant in the femoral level. The cross-sectional ACL area at the femoral level is significantly small, however, the blood capillaries were most abundant. Therefore, when the ACL is injured, its reconstruction with preservation of the femoral ligamentous remnant may be clinically useful for remodeling of the grafted tendon. [ABSTRACT FROM AUTHOR]

Because itprovides stability and support to the body and also because of its location, the knee is one of the most important structures in our body and, therefore, the joint with the highest probability of suffering any type of injury. Thus, any injury, damage or minimal dysfunction that occurs, ends up causing afunctional imbalance in the injured individual. The study sought to evaluate the effectiveness of a multidisciplinary protocol for the rehabilitation of individuals who suffered ACL injuries and underwent surgical intervention for ligament reconstruction. Descriptive case series study with therapeutic intervention and quantitative approach. Five men with a clinical diagnosis of total ACL tear participated in the study and underwent surgical intervention to reconstruct the ligament through the patellar tendon. The assessment of range of motion, the Thomas and Ely manual tests, the strength of the lower limbs with a 10 RM test and the IKDC and Lysholm questionnaires were applied to each patient. The objectives that were proposed by the multidisdplinary rehabilitation protocol were achieved, so that the study participants gained ROM, muscle strength gain, improved quality of life and especially the achievement of good functionality. The protocol consisted of four microcycles and was performed by each patient in a total of 36 sessions. The research showed that carrying out a multidisciplinary protocol focused on the rehabilitation of patients with ACL injuries and surgical intervention was effective for the participants of this study. [ABSTRACT FROM AUTHOR]

Aim: Knowing that there is still no consensus on the subject and the results are conflicting, the objective of the present study was, through a systematic review, to describe the results with the greatest evidence available in the literature on the ACL reconstruction technique using autograft patellar tendon and quadriceps tendon, understanding their indications and updates on the level of recommendation. Methods: Specific descriptors were searched in the Pubmed, Medline and Embase databases, for studies published up to January 2, 2022. The following descriptors were used: Reconstruction; Anterior Cruciate Ligament; ACL; Quadriceps tendon; Patellar tendon; Autograft; Treatment; Knee. The following filters were used to arrive at the expected final result: "Randomized Controlled Trial; "Randomized Clinical Trial" "Meta-Analysis" "Systematic Reviews" "Clinical Trial". Results: According to the search strategy, 64 studies were found with the aforementioned descriptors, which were again evaluated according to their design and relevance according to the filters of the type of study and inclusion criteria. In the end, 11 complete studies were left that described the clinical results of the comparison between the types of graft in ACL reconstruction, all of which were included. A total of 758 patients with a mean age of 28.8 years (range 16 to 68 years) were included. Mean follow-up time between studies was variable, from 12-48 months. Conclusion Through this systematic review, it was possible to observe similar clinical and functional results of TP and TQ grafts. New data suggest that the quadriceps tendon autograft may have superior biomechanical characteristics when compared to the TP autograft. However, there are few prospective randomized studies that conclusively carry out this investigation. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El balonmano es un deporte que requiere la repetición de movimientos y acciones de alta intensidad, como aterrizajes con una pierna y acciones de uno contra uno, que favorecen el mecanismo lesivo del ligamento cruzado anterior. El entrenamiento preventivo puede identificar los factores de riesgo neuromusculares asociados al riesgo de sufrir esta lesión en deportistas femeninas. Determinar sus características (duración, frecuencia, tipo de ejercicio…) y componentes (fuerza, pliometría, equilibrio…) es fundamental a la hora de diseñar un entrenamiento que sea específico e individualizado para la jugadora. Los objetivos de este trabajo fueron identificar y categorizar los componentes comunes de los programas de entrenamiento preventivo de la lesión del ligamento cruzado anterior en jugadoras de balonmano y describir y clasificar los ejercicios que conforman cada categoría. Se realizó una revisión sistemática siguiendo las directrices de la declaración PRISMA en las bases de datos Web of Science, Sport Discus, PubMed, Scopus, Cochrane y ScienceDirect. Los criterios de inclusión fueron: (a) las participantes eran jugadoras de balonmano de cualquier edad y sexo femenino, (b) había una intervención con un entrenamiento preventivo, y (c) se informaba de la incidencia lesiva con el número de lesiones de LCA. Se incluyeron seis estudios y se evaluó su calidad metodológica mediante la herramienta ROB 2.0. Los resultados indican que la mayoría de intervenciones incluían más de un componente de entrenamiento con una duración media de 15 minutos y que los ejercicios que más variaban entre los diferentes programas fueron los de pliometría.

Introducción: los factores de riesgo de re-ruptura de LCA son errores técnicos, características del injerto, lesiones meniscales, condrales o lesiones no tratadas. El objetivo de nuestro trabajo fue reconocer predictores modificables que nos ayuden a obtener un mejor resultado en la cirugía de revisión de LCA. Materiales y métodos: estudio descriptivo transversal. Serie de pacientes tratados en nuestro centro entre 2011 y 2021 a los cuales se les realizó cirugía de revisión de LCA. Se registraron edad, sexo, falla de cirugía primaria traumática, o no, fijación utilizada, ubicación de ambos túneles, injerto utilizado en la cirugía primaria, lesiones articulares condrales y meniscales antiguas y nuevas y tipo de injerto utilizado en cirugía de revisión. Resultados: se analizaron un total de ciento nueve pacientes. Con mayor frecuencia, los pacientes masculinos se sometieron a revisión entre los veinte y los cuarenta años. La principal causa traumática fue la práctica deportiva (40.37%), seguida de accidente de tránsito o en domicilio (7.33%) y en ambiente laboral (24.8%), y sin causa demostrable (27.5%). La mala posición del túnel femoral aislada fue la falla técnica más común en un 41.29%, sin error técnico en 38.53%, y falla de colocación de túnel tibial aislada en 2.75%. En el total de los pacientes evaluados, el 28.44% (treinta y un pacientes) no presentó lesión meniscal previa ni actual; mientras que el 71.56% (setenta y ocho pacientes) evidenció algún tipo de lesión. La elección del injerto fue autoinjerto de H-T-H (30.28%), aloinjerto de tibial posterior (30.28%), aloinjerto de tibial anterior (19.27%), autoinjerto de ST-RI (11.01%), y otros aloinjertos Aquiles, Peroneos y ST (9.17%). Discusión: serán necesarios más estudios para determinar si esta tasa de falla persiste a pesar de nuestro mayor conocimiento de la técnica y diversos aspectos de la cirugía de revisión.

OBJETIVO: Identificar a taxa de lesão de LCA em jovens atletas de futebol. MÉTODOS: A metodologia contou com a busca sistemática dos artigos em 4 bases de dados: “Pubmed/Medline”, “Science Direct”, “Web of Science” e “Lilacs” através dos seguintes descritores combinados: “Anterior Cruciate Ligament”, “Injury”, “Adolescents”, “Soccer Players” e “Athletes”. Foram selecionados para a revisão os estudos de 2016 a 2021 com dados referentes a lesões de LCA em atletas com idades dos 13 aos 18 anos de ambos os sexos. A revisão seguiu as diretrizes PRISMA, e avaliação da qualidade metodológica foi realizada através da lista de verificação STROBE. RESULTADOS: Foram encontrados 544 estudos, sendo selecionados os publicados no período de 2016 a 2021 (144). Através das etapas de leitura dos títulos (89), dos resumos (66), e dos artigos na íntegra (13), foram selecionados 4 estudos que atenderam o critério de inclusão apresentando desfecho sobre a taxa de lesões, onde se constatou maior incidência de lesões do LCA para meninas. Apesar disso, apenas dois dos estudos averiguou a incidência em relação a outras características (atividade, mecanismo, evento) de forma específica. CONCLUSÃO: Concluiu-se que a taxa de lesões de LCA é significativamente maior em meninas do que em meninos durante adolescência, tendo características de lesões sem contato e ocorrendo principalmente em competições, porém ainda são escassos os dados a respeito da natureza destas lesões.

La rotura de ligamento cruzado anterior constituye una de las lesiones más comunes en adultos jóvenes y por ende se considera vital su reconstrucción de manera efectiva para disminuir la inestabilidad residual especialmente la residual, por lo que está en auge la reconstrucción del ligamento anterolateral. Objetivo: determinar la efectividad de la reconstrucción del ligamento anterolateral en pacientes con lesión de ligamento cruzado anterior que son atendidos en la Unidad de Rodilla del Centro Médico Docente la Trinidad desde enero del 2020 a Julio del 2022. Metodología: estudio observacional analítico de casos y controles tipo II o binomial de distribución factorial con emparejamiento, prospectivo atemporal. Resultados: en los datos obtenidos en el presente estudio se observó que la muestra en los cuatro grupos fue homogénea con resultados similares en las variables tanto descriptivas como de factores de riesgo. En el puntaje de escala de Lysholm Contrastando los resultados anteriormente señalados se evidencio una diferencia entre todas las mediciones especialmente la de 6 meses donde vario entre casos y controles en más de 10 puntos de mejoría en el grupo donde se realizó la reconstrucción del ligamento anterolateral con la T de Student con un nivel de significancia (p< 0,05). Conclusión: se comprueba la efectividad clínica de la reconstrucción anterolateral en lesiones del ligamento cruzado anterior tanto clínicamente como con significancia estadística.

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Objectives: This study aims to determine the differences between genders by measuring the anterior cruciate ligament (ACL) related bony structures on the femur and tibia, which belong to the same individuals. Materials and Methods: The study included 219 bones [108 femurs (74 male/34 female) / 111 tibias (72 male/39 female)]. On the distal femur, bicondylar width (BCW) and intercondylar notch width (NW) were measured, and the intercondylar notch width index (NWI) was calculated as NW/BCW. On the proximal tibia, tibial width (TW) and tibial eminence width (EW) were measured, and the tibial eminence width index (EWI) was calculated as EW/TW. Results: In this study, the BCW, NW, and NWI parameters were determined to be 65.90±3.23, 20.91±2.39, 0.31±0.03 in females, and 75.08±3.96, 23.45±2.80, 0.30±0.03 mm in males, respectively. The TW, EW, and EWI parameters were determined to be 66.05±5.83, 8.89±1.48, 0.13±0.02 in females and 75.74±4.29, 11.02±1.96, 0.14±0.02 mm in males, respectively. Conclusions: This study showed morphological differences between genders, which is anatomically unavoidable. Also, the femur and tibia structures are statistically significantly correlated, and it would be more accurate to look for answers to ACL injuries by studying both bones together. [ABSTRACT FROM AUTHOR]

Objetivo: descrever os efeitos da intervenção fisioterapêutica no pré-operatório de lesão do ligamento cruzado anterior (LCA). Materiais e Métodos: trata-se de um relato de caso de paciente do sexo feminino, 31 anos, fisicamente ativa, apresentando rotura do LCA esquerdo com indicação médica para intervenção cirúrgica. A paciente referia dor no segmento acometido e apresentava edema, déficit de extensão, hipotrofia do quadríceps e diminuição de força muscular no membro inferior. Para a avaliação da intensidade da dor, foi utilizada a Escala Visual Analógica. O tratamento consistiu em 12 atendimentos quando foram realizados exercícios de descarga de peso, alongamento muscular estático, fortalecimento com o auxílio de caneleira e resistências elásticas enfatizando o complexo posterolateral do quadril e o quadríceps, treino sensoriomotor e propriocepção. Resultados: observou-se diminuição da intensidade de dor, redução do edema, ganho de amplitude de extensão do joelho e aumento de força muscular, com relato de melhora de funcionalidade e da qualidade de vida. Conclusão: o tratamento fisioterapêutico mostrou-se importante no pré-operatório de lesão do LCA, proporcionando maior confiança ao paciente e reduzindo o risco de complicações após o procedimento cirúrgico.

Objetivo: estimar a prevalência de retorno ao esporte (RE) após cirurgia para reconstrução do ligamento cruzado anterior (R-LCA), e investigar a função física e a prontidão psicológica para o RE. Materiais e Métodos: estudo transversal realizado na cidade de Montes Claros (MG), aprovado pelo Comitê de Ética em Pesquisa da FUNORTE com Parecer nº 4.964.136/202. A amostra foi composta por 20 indivíduos do sexo masculino que realizaram reconstrução do ligamento cruzado anterior há, pelo menos, um ano. A coleta dos dados ocorreu de setembro a novembro de 2021. Para a avaliação de dor/função, prontidão psicológica e prevalência de RE, foram aplicados os questionários Lysholm Knee Scoring Scale, Anterior Cruciate Ligament Return to Sport after Injury e um questionário semiestruturado, respectivamente. Resultados: a prevalência de RE após R-LCA foi de 90%. A média do escore do LKSS foi de 70,9±12,1. Os fatores psicológicos de maior influência sobre o RE foram o medo de acidentalmente lesionar o joelho durante prática esportiva (7,5±2,4) e a crença de re-lesão no esporte (4,1±2,8). Observou-se maior prevalência de dor durante exercícios pesados (50%) e rara instabilidade durante atividades atléticas ou outros exercícios pesados (40%). 35% dos sujeitos relataram não conseguir agachar-se normalmente e 25% dos indivíduos afirmaram claudicar mesmo após o tratamento. Conclusão: há alta prevalência de retorno ao esporte após a reconstrução primária do LCA e que fatores psicológicos associados a crenças disfuncionais podem estar presentes, mesmo após o período completo de reabilitação preconizado pela literatura.

Purpose of the study: determine the sensitivity and specificity of magnetic resonance imaging in anterior cruciate ligament injuries and associated injuries through arthroscopic findings. Material and methods: this is a retrospective, longitudinal, cross-sectional study in 96 patients with ACL injuries were included and who underwent arthroscopic surgery; arthroscopic findings were compared with diagnostic magnetic resonance images as well as associated lesions. Results: for ACL lesions the following data were found in relation to the agreement by MRI and arthroscopic findings; 93.68% sensitivity, 100% specificity. Negative predictor value of 14.28% and a positive predictor value of 100%. Conclusion: MRI is an accurate and non-invasive imaging modality for the evaluation of knee injuries, the diagnostic association is considerably high. [ABSTRACT FROM AUTHOR]

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Cuando se presentan pacientes con ruptura bilateral del ligamento cruzado anterior y requieren cirugía reconstructiva, se puede optar por procedimientos de reconstrucción unilateral a la vez. Este tipo de abordaje terapéutico ha sido descripto en la literatura, sin embargo, existe muy poca evidencia acerca de la reconstrucción simultánea o secuencial de ambas rodillas en el mismo acto quirúrgico. En este trabajo se presenta un caso de reconstrucción secuencial en el mismo acto quirúrgico, con un solo tiempo anestésico, realizado por un solo equipo quirúrgico en un paciente con ruptura bilateral de ligamento cruzado anterior. Además, se desarrolla una actualización del tema y se compara este procedimiento con aquellos efectuados en dos actos quirúrgicos, desde el punto de vista económico, clínico y funcional, el plan de fisioterapia adoptado y los resultados a mediano plazo mediante la escala de Lysholm.

La ruptura del ligamento cruzado anterior (LCA) es una lesión frecuente en la población general, con una incidencia de hasta 75/100.000 personas por año. Hombres y mujeres jóvenes, involucrados en deportes de contacto y colisión, suelen ser los más afectados. La reconstrucción artroscópica se ha convertido en el estándar de tratamiento, con cerca de doscientos mil procedimientos por año en EE. UU. Los injertos se clasifican según sus elementos constituyentes (hueso-tendón-hueso, hueso-tendón o tendón), o el origen del dador (autoinjerto o aloinjerto). A pesar de su alta prevalencia, el injerto ideal sigue siendo motivo de debate en la bibliografía. Consideramos que su elección debe basarse en la experiencia del cirujano con los diferentes injertos y en las características individuales de cada paciente.

Introducción: la reconstrucción del ligamento cruzado anterior (LCA) con injerto autólogo con la porción tendinosa de los músculos grácil y semitendinoso ha ganado popularidad. El emplazamiento de la incisión para cosechar dicho injerto y la cantidad de tejido disponible son claves a la hora de su utilización. El estudio cadavérico y ecográfico permite evaluar mejor sus propiedades con aplicación quirúrgica. Materiales y métodos: estudio descriptivo transversal. Se disecaron veinticuatro miembros inferiores de adultos, formolados. Se realizó ecografía de partes blandas en dieciocho miembros inferiores de adultos de ambos sexos. Se midieron los tendones de los músculos grácil y semitendinoso en longitud y diámetro. Se topografió su inserción en relación al borde anterior de la tibia (BAT) y a la interlínea articular (IA). Resultados: en el estudio cadavérico, la inserción promedio del grácil fue a 2.7 cm del BAT y 4.6 cm de la IA, y del semitendinoso fue a 2.7 cm del BAT y 5.7 cm de la IA. El diámetro y longitud de los tendones fue de 0.55 cm y 13.29 cm, respectivamente, para el grácil y de 0.68 cm y 16.42 cm para el semitendinoso. La ecografía mostró valores estadísticamente distintos en todas las variables. Se establecieron regresiones lineales significativas entre el largo de la pierna y la longitudes de los tendones, así como la distancia a la IA. Conclusiones: el presente estudio aporta información precisa sobre el punto de inserción de los dos músculos. Las propiedades morfológicas de ambos tendones se prestan para su utilización como injerto. La ecografía no mostró resultados comparables con los cadavéricos.

La lesión del ligamento cruzado anterior (LCA) en la rodilla es muy común a nivel mundial. Cada año se calculan de 4 a 10 casos por cada mil habitantes. Objetivo de la investigación consistió en evaluar la reconstrucción del LAL en la inestabilidad rotacional de la rodilla asociada a ruptura del LCA, en los pacientes que asisten al CMDLT. El método de la investigación fue de tipo analítica, de campo, prospectivo. La muestra estuvo conformada por 30 pacientes que cumplieron con los criterios de inclusión. Los sujetos de estudio fueron en un alto porcentaje de sexo masculino (80%), edad de 31,63±11,51. 100% de los pacientes utilizaron como métodos diagnósticos Lachman y Pivot Shift 3+. Hubo diferencias entre las medias de la Escala de Tegner Lysholm del pre y a los 3 meses (p0,05) entre el tipo de injerto en los diferentes momentos de estudio. 6,7%, presentaron como complicación hematoma en el muslo. Se concluye que la técnica quirúrgica de reconstrucción del LCA en inestabilidad rotacional de rodilla asociada a ruptura del ligamento cruzado anterior fue efectiva.

Introduction: the tibial slope has been identified as one of the factors associated with graft failure after anterior cruciate ligament (ACL) reconstruction; however, its relationship with functional results has been little studied. The main purpose of this study is to determine the effect of the tibial slope on functional recovery in patients undergoing reconstruction of the anterior cruciate ligament. Material and methods: we included patients with a diagnosis of anterior cruciate ligament injury undergoing primary reconstruction, from May 2018 to May 2019, who had a complete radiographic and clinical record; also, the scores from questionnaires of the International Knee Documentation Committee (IKDC) and Lysholm scores were collected pre surgical procedures and throughout the one-year follow-up. The measurement of the tibial slope was performed in lateral knee X-rays from the electronic clinical record. A descriptive analysis of first intention was done, and to achieve the objectives, we compared 25 patients who had normal tibial slope that were selected randomly with 25 patients who had increased tibial slope. Results: a total of 98 patients were included, 73 had a normal tibial slope (equal to or less than 12 degrees) and 25 with an increased tibial slope (greater than 12 degrees), the average age in both groups was 28.43 years for the group with normal tibial slope and 28.26 for patients with increased tibial slope. Regarding the functional assessment, the IKDC and Lysholm scores at the end of the follow-up were better for patients with normal tibial slope. Graft failure was only identified in the group with increased tibial slope. On the other hand, the comparative analysis with the control group randomly selected who had normal tibial slope, showed a better functional result assessed by IKDC score at the end of the follow-up for the group with normal tibial slope. Conclusion: patients undergoing ACL reconstruction and increased Tibial Slope have an inferior functional result at one year of follow-up assessed by IKDC, when compared with patients with normal tibial slope. [ABSTRACT FROM AUTHOR]

Introducción. Las diferencias en la activación muscular de las porciones lateral y medial del cuádriceps durante la ejecución del salto, pueden convertirse en un factor de riesgo neuromuscular al aumentar el valgo dinámico de rodilla y, en consecuencia, el riesgo de lesión del ligamento cruzado anterior de la rodilla. Objetivo. Determinar la diferencia en la activación de los vastos lateral y medial del cuádriceps mediante electromiografía de superficie durante el salto con una sola pierna en los planos sagital y frontal en mujeres deportistas. Materiales y métodos. Se hizo un estudio cuantitativo de corte transversal con la participación de 64 mujeres deportistas a quienes se les tomaron las medidas antropométricas. Se hicieron pruebas de salto vertical y lateral con una sola pierna evaluados mediante la activación electromiográfica de los vastos medial y lateral, y la valoración de la flexibilidad de la banda iliotibial. Resultados. Se encontró una relación estadísticamente significativa (p≤0,05) entre el índice de masa corporal, el porcentaje de grasa y la potencia en los saltos verticales con una sola pierna. Se encontró, asimismo, significación estadística (p≤0,05) por una mayor activación del vasto lateral en el salto vertical con la pierna derecha y en el salto lateral con las dos piernas. Conclusión. Las deportistas presentaron diferencias en la activación de los cuádriceps, siendo mayor la activación del vasto lateral en la mayoría de los saltos con una sola pierna tanto en el plano sagital como en el frontal, lo cual puede contribuir a un aumento del riesgo de lesión de rodilla en la práctica deportiva.

Introduction: Return to sports (RTS) is maybe the main expectation for the patient after anterior cruciate ligament reconstruction (ACLR). The aim of this study was to analyze the psychological readiness to RTS in a cohort of amateur sports after ACLR. Material and methods: Retrospective study of a prospective database of patients treated with ACLR performed between January and December 2017. Psychological readiness to RTS after ACLR was evaluated with the short version of the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scale. Results: A total of 43 patients met the inclusion criteria. The mean age of the patients was 24.7 years. The mean follow-up was 32.5 months. All patients practiced any type of sports at final follow-up. The mean ACL-RSI score was 71.5. Fear of reinjury was mentioned by 14 patients (32.5%). Twenty-four patients (55.8%) pointed out that they did not practice sport at the pre-injury level. The mean ACL-RSI score was statistically significant lower in this group of patients (59.7 vs 87.3; p

Background: Given the boom in sports in school age, its intensity and the increase in sports in females, we are experiencing a boom in sports injuries characteristic of "adults" in growing patients, the anterior cruciate ligament being an injury with possible serious consequences., Methods: To show the surgical technique "without bone tunnels" by Micheli-Kocher in anterior cruciate ligament reconstruction in growing patients based on our results in 20 patients., Results: Since 2017 we have performed the technique "without bone tunnels" by Micheli-Kocher in 30 patients, 20 of whom have been followed up for more than 2 years. In our study, we have observed a return to previous sports activity in more than 90% of the patients, with only one patient undergoing reoperation due to a new rupture of the plasty. The results on the IKDC scales show an improvement in mean score from 42 points preoperatively to 84 postoperatively and on the Lysholm scale from 48 preoperatively to 94 postoperatively., Conclusions: The technique "without bone tunnels" by Micheli-Kocher is a technique indicated in patients under 12 years of age and Tanner stage 2 or less. It is a technique of moderate complexity with excellent results in recovery from previous sports activity and knee stability., (Copyright © 2024 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4 DSP) into Spanish., Methods: A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4 DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated., Results: The S-4DSP was fully completed by 108 participants (mean age 34±10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively., Conclusions: The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction., (Copyright © 2024 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4DSP) into Spanish., Methods: A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated., Results: The S-4DSP was fully completed by 108 participants (mean age 34±10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively., Conclusions: The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction., (Copyright © 2024 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

A incidência de injuria no ligamento cruzado anterior é uma das mais rotineiras, seja por acidentes domiciliares, automobilístico e é o principal ocasionador de lesões esportivas, sendo necessária intervenção cirúrgica, mas nos casos de ruptura parcial, sem indicativos de cirurgia, é realizado tratamento preventivo com a fisioterapia .Trata-se de uma revisão integrativa qualitativa da literatura, publicados entre os anos de 2000 e 2020 nas bases de dados: SciELO, Biblioteca Virtual em Saúde, PubMed. Teve como resultado 08 artigos selecionados que compuseram o artigo. As condutas do fortalecimento devem abordar treinos unilateral, para o lado acometido pelas injuria do LCA, e bilaterais, promovendo um melhor condicionamento das estruturas e diminuindo/evitando o desequilíbrio das forças biomecânicas. Concluindo que o tratamento conservador do LCA é uma terapêutica eficiente para ser utilizada na recuperação desses indivíduos, pois oferece uma recuperação rápida e eficiente quando o grau de comprometimento não é tão grave. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study is to compare the functional result of the suspensory graft versus screw technique for biotenodesis. Methodology: Patients with an anterior cruciate ligament injury who were treated at the General Hospital Ignacio Zaragoza of the ISSSTE were captured and evaluated one year after surgical treatment using the Tegner and Lysholm Score. Results: As a result, it was obtained that the suspensory mechanism with graft is the technique that shows the best results on the Lysholm scale and the biotenodesis screw on the Tegner functional scale. Limitations or implications: Considering 39 patients for the elaboration of this research, it could be considered as a limitation Originality or value: Its importance lies in the fact that both surgical techniques were performed by the same surgeons and that it is a study in the Mexican population, being a contribution to the literature of this country. Findings or conclusions: It is concluded that in order to determine which technique is better, it must be determined whether the symptoms or functional recovery will be evaluated. [ABSTRACT FROM AUTHOR]

Objetivo: reportar los resultados del programa de ejercicios domiciliarios incrementales con mínima supervisión (PEDIMS), compatibles con el confinamiento, en el preoperatorio de lesiones de LCA, enfatizando la activación excéntrica de los isquiosurales agonistas del LCA. Materiales y métodos: se estudiaron seis hombres con lesiones del LCA en el preoperatorio para su reconstrucción. Se registraron las medidas de fuerza de los isquiosurales antes y después de realizar el PEDIMS, utilizamos el instrumento original DINABANG para obtener dichas mediciones. Este programa se implementó durante cuatro semanas; solamente se hicieron cinco consultas presenciales, el resto lo realizaron los pacientes en su domicilio. Resultados: comparando la rodilla sana contralateral, fuerza de 2.17 N/kg, con la lesionada, preentrenamiento y posentrenamiento, se observa el aumento de la fuerza de los isquiosurales en la rodilla con lesión del LCA, de 1.63 N/kg a 1.92 N/kg, respectivamente. Partiendo de una satisfacción subjetiva del 67% según el score de Lysholm, el entrenamiento logra un 87% de satisfacción; estos resultados son estadísticamente significativos. Conclusiones: para su aplicación en etapa preoperatoria del LCA, el PEDIMS es un programa clínico de fortalecimiento muscular flexor de la rodilla que reduce el número de sesiones presenciales, lo que le confiere al método una clara vigencia en épocas de pandemia o reducción presupuestaria.

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Copyright of RICYDE. Revista Internacional de Ciencias del Deporte is the property of Revista Internacional de Ciencias del Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)