Rehabilitation News

There is no question in my mind that the ideal ACL graft for an active older patient who is uncomfortable with an allograft is a quadrupled semitendinosus autograft. By quadrupling the tendon, sufficient size and strength of the graft can be achieved. The fact that the quadrupled graft may be shorter can easily be accommodated by using an all-inside technique with bony sockets. With the harvesting of only a single hamstring, the risk of harvest morbidity is low and there is little early postoperative pain. This allows early weight-bearing and shorter time on crutches, which should decrease the risk of deep vein thrombosis or falls. The harvesting is relatively straightforward and can be performed quickly without a tourniquet. Any resulting minor hamstring weakness is unlikely to be noticed in these patients. With respect to concerns about graft retear, because the risk of ACL graft retear declines with age, as much as 50% for each decade of life, retear rates should be low. There is a reason hamstring grafts are the most commonly used grafts for ACL reconstruction worldwide and the benefits of this graft choice are amplified in the older population. In addition, any potential downsides of hamstring graft use are minimized in this age group.

The ACL is reportedly one of the most commonly injured knee ligaments among professional- and recreational-level athletes, with a high risk for primary and secondary ACL injuries found with participation in pivoting and cutting sports, such as football, basketball, skiing and soccer.

In August 2018, Gov. Bruce Rauner, R-Ill., signed into law a bill that would allow patients in Illinois to seek out the services of a physical therapist without a referral from a physician or orthopedic surgeon. This expands previous policies on direct access to physical therapy for patients.

Patients who participated in late-stage exercise programs after total knee replacement saw no benefits in WOMAC physical function compared with patients who received the usual care, according to a published study.

When parents are faced with a decision regarding the optimal treatment for their child with an ACL injury, they commonly ask, “If this was your child, what would you do?” For most, the answer is easy. We want the best surgeon to decide the best treatment that has the best outcome and the least probability of a complication. Interestingly, the paucity of high-level evidence in this area does not support the general consensus of pediatric sports medicine experts. The pendulum continues to swing as historical dogma in the treatment of pediatric ACL injuries was to delay until skeletal maturity. However, recent advances in techniques have suggested a safe alternative is early surgical treatment of ACL injuries.

PARK CITY, Utah — Following total hip or knee arthroplasty, inpatient physical therapy is not better than outpatient physical therapy and outpatient physical therapy is not better than home-based physical therapy, according to Rafael J. Sierra, MD, who based those statements on a review of the literature he discussed at the Joint Arthroplasty Mountain Meeting.

Patients who participated in a prehabilitation protocol for total knee arthroplasty experienced shorter length of stay and better discharge disposition, according to results published in The Annals of Translational Medicine.

At the South Ural State University School of Electrical Engineering and Computer Science and Institute of Sport, Tourism and Service, a team of scientists is preparing for the final stage of development in a 4-year endeavor to create a new rehabilitation device for patients with lower leg injuries.

Early physical therapy may correlate with a decrease in long-term and low-intensity opioid use for pain in musculoskeletal regions among opioid-naïve patients, according to recently published results.

Patients with chronic musculoskeletal conditions experienced better function and were able to more effectively and independently manage their condition if they participated in a Pilates based exercise program, according to data published in Musculoskeletal Care.