Rehabilitation Following ACL Repair with Internal Brace Ligament Augmentation in Female Gymnast: A Resident's Case Report.

IF 1.6 Q3 SPORT SCIENCES International Journal of Sports Physical Therapy Pub Date : 2024-06-01 eCollection Date: 2024-01-01 DOI:10.26603/001c.117773
Colten Haack, Giorgio Zeppieri, Micheal W Moser
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Abstract

Introduction: Anterior Cruciate Ligament (ACL) injuries continue to be a major source of morbidity in gymnastics. The gold standard is to perform an ACL Reconstruction (ACLR). However, injuries to the proximal femoral attachment of the ACL have demonstrated an ability to regenerate. An alternative surgical intervention to the ACLR in this ACL tear subgroup is an ACL repair. The purpose of this case report is to provide a rehabilitation progression for a female gymnast after an ACL repair with Internal Brace Ligament Augmentation (IBLA).

Case description: The subject was a 16-year-old female who presented with a Sherman Type 1 proximal avulsion of her ACL. She underwent an ACL repair with IBLA. Physical therapy interventions followed a sequential and multi-phased approach based on time for tissue physiologic healing and individual progression. Patient reported outcomes including the International Knee Documentation Committee (IKDC), the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) were assessed in conjunction with isokinetic strength and hop performance testing to determine return to sport readiness.

Outcomes: The subject completed 42 sessions over the course of 26 weeks in addition to a home exercise program. At return to sport, clinically meaningful improvement was observed in patient reported outcomes including the IKDC, ACL-RSI, and OSPRO-YF. Additionally, strength and hop performance surpassed established thresholds of clinical significance. The subject returned to sport at six months post-operatively.

Conclusion: The subject in this case report returned to full participation in gymnastics six months after an ACL repair with internal bracing following a sequential and multi-phased rehabilitation. The primary ACL repair with IBLA appeared beneficial to this patient and could benefit from additional study in other athletes and athletic populations.

Level of evidence: Level 5.

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女体操运动员前交叉韧带修复术后的康复与内支架韧带增强术:一名住院医师的病例报告。
导言:前十字韧带(ACL)损伤仍然是体操运动中的主要发病原因。金标准是进行前交叉韧带重建术(ACLR)。然而,前交叉韧带股骨近端附着处的损伤已被证明具有再生能力。在前交叉韧带撕裂亚组中,前交叉韧带修复术是替代前交叉韧带重建术的另一种手术疗法。本病例报告的目的是为一名体操女运动员提供前交叉韧带修复术(IBLA)后的康复进展情况:病例描述:患者是一名 16 岁的女性,前十字韧带谢尔曼 1 型近端撕脱。她接受了前交叉韧带修补术和 IBLA。物理治疗干预根据组织生理愈合时间和个体进展情况采取了有序、多阶段的方法。患者报告的结果包括国际膝关节文献委员会(IKDC)、前交叉韧带损伤后恢复运动(ACL-RSI)和转诊和结果黄旗预测最佳筛查(OSPRO-YF),并结合等动力量和跳跃性能测试进行评估,以确定恢复运动的准备情况:受试者在 26 周内完成了 42 次训练,此外还参加了家庭锻炼计划。在恢复运动时,患者报告的结果(包括IKDC、ACL-RSI和OSPRO-YF)均有临床意义的改善。此外,力量和跳跃表现也超过了既定的临床意义阈值。受试者在术后六个月重返运动场:结论:本病例报告中的受试者在前交叉韧带修复术后 6 个月,经过有序、多阶段的康复治疗后,完全恢复了体操运动。采用 IBLA 进行前交叉韧带初次修复似乎对该患者有益,可在其他运动员和运动人群中进行更多研究:证据等级:5 级。
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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