ACL Rehabilitation AND Return to play...2016/07/09  · ACL REHABILITATION AND RETURN TO PLAY BY...

ACL REHABILITATION AND RETURN TO PLAY

BY

EDDY L ECHOLS, JR., MD.

DEFINE RETURN TO PLAY

EXPECTATIONS AND REALITY OF RETURN TO PLAY

Arden CL, Webster KF, Taylor NF, Feller JA:

Return to sport following Anterior Cruciate Ligament

Reconstruction surgery: A systematic review and meta-

Analysis of the state of play. Br J Sports Med 2011;45(7):596-606.

FACTORS THAT AFFECT RETURN TO PLAY

• Physiologic

• Psychologic

Psychologic Impact on Return to Play( The Fear of Re-injury)

PSYOLOGIC FACTORS THAT AFFECT RETURN TO PLAY

• Pre-operative

• Intra-operative

• Post operative

PRE-OPERATIVE

• Inflammation/Pain

• Swelling

• Range of Motion

EFFECT ON RETURN TO PLAY

• Stiffness/ Arthrofibrosis( Pre-op Range of Motion best predictor of Post-op)

• Increased Patello-Femoral Contact

• Pain and Altered Gait

INTRA-OPERATIVE FACTORS

• Tunnel Placement

• Graft Choice

• Graft Fixation

GRAFT CHOICE

• Autograft

• Allograft

AUTOGRAFTS

• BTB

• Hamstring

• Quadriceps

GRAFT FIXATION

• Aperture fixation ( Various Techniques)

• Suspensory Fixation

POST OPERATIVE FACTORS

• Rehab

• Rehab

• Rehab

Casio et al.”Return to Play after Anterior Cruciate Ligament

Reconstruction.”Clin Sports Med.2004; 23(3), 395-408.

Shelbourne KD, Nitz P: Accelerated Rehabilitation

after Anterior Cruciate Ligament Reconstruction.

J Orthop Sports Phys Ther 1992;15(6):256-264.

• Beynnan BD, Uh BS, Johnson RJ,et al: Rehabilitation after Anterior Cruciate Ligament reconstruction: A prospective randomized, double blind comparison of programs administered over two different time intervals. Am J Sports Med 2005;33(3): 347-359.

THANK YOU