Weightbearing Strategies for Knee Injury Rehab
Recruiting in Palo Alto (17 mi)
Age: < 65
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Twin Cities Orthopedics
No Placebo Group
Trial Summary
What is the purpose of this trial?This is a prospective randomized controlled trial with the purpose to determine if patients undergoing fibular collateral ligament (FCL) reconstruction alone or combined FCL and anterior cruciate ligament (ACL) reconstructions can safely begin full controlled weightbearing for the first six weeks after surgery.
What safety data exists for weightbearing strategies in knee injury rehab?Safety data for weightbearing strategies in knee injury rehab, particularly after ACL and FCL reconstructions, indicate that early weightbearing protocols are advocated for ACL reconstruction, but are less defined for FCL reconstruction. ACL reconstruction is generally safe and effective, though it carries risks such as infection, which is rare but serious. Complications are known but often underestimated. FCL reconstruction has a higher reoperation rate if repaired rather than reconstructed, and can be combined with other ligament reconstructions. Overall, these procedures are considered safe with known risks.89101112
Is ACL and FCL reconstruction a promising treatment for knee injury rehab?Yes, ACL and FCL reconstruction is promising for knee injury rehab because it helps restore knee function, reduces pain and swelling, and improves strength and stability. Early weight-bearing exercises are effective in rehabilitation, helping patients return to their pre-injury status.234511
What data supports the idea that Weightbearing Strategies for Knee Injury Rehab is an effective treatment?The available research shows that Weightbearing Strategies for Knee Injury Rehab, particularly after ACL reconstruction, are effective. For example, the Knee Symmetry Model reported that 100% of patients achieved normal knee extension and 97% achieved normal knee flexion. This suggests that the treatment helps restore normal knee movement. Additionally, the research highlights that early weight bearing and specific exercises are important for recovery, helping patients return to their pre-injury activities. Compared to other treatments, these strategies focus on achieving symmetry in knee movement and strength, which is crucial for effective rehabilitation.12567
Do I have to stop taking my current medications for the trial?The trial protocol does not specify whether you need to stop taking your current medications.
Eligibility Criteria
This trial is for males and females aged 14 to 60 who are undergoing fibular collateral ligament (FCL) reconstruction, with or without anterior cruciate ligament (ACL) surgery. Participants must be able to follow the study plan and give informed consent. It's not for those with certain other knee surgeries, pregnant individuals, under 14 or over 60 years old.Inclusion Criteria
I am between 14 and 59 years old.
I have had both FCL and ACL knee reconstructions.
Exclusion Criteria
I am younger than 14 or older than 60.
I am undergoing or have undergone repairs on my thigh muscle or outer knee capsule.
I am having surgery to repair a knee injury using a specific technique.
I am having or have had surgery to repair my PCL or MCL.
Participant Groups
The study is testing whether patients can safely start full weightbearing during the first six weeks of rehab after FCL reconstruction alone or combined with ACL surgery. This will be determined through a randomized controlled trial comparing full versus partial weightbearing.
2Treatment groups
Experimental Treatment
Active Control
Group I: Full weight -bearing for the first six weeks after surgeryExperimental Treatment1 Intervention
If the patient is randomized to the full weightbearing group, the patient will be instructed about acceptable exercises and activities.
Group II: Partial weight -bearing for the first six weeks after surgeryActive Control1 Intervention
Partial weightbearing will be defined as 40% of the patient's body weight.
Anterior Cruciate Ligament Reconstruction is already approved in United States, European Union, Canada, Japan for the following indications:
🇺🇸 Approved in United States as ACL Reconstruction for:
- Knee instability due to ACL tear
- Combined ACL and meniscal injuries
- Chronic ACL deficiency
🇪🇺 Approved in European Union as Anterior Cruciate Ligament Repair for:
- Knee instability due to ACL tear
- Combined ACL and meniscal injuries
- Chronic ACL deficiency
- Pediatric ACL injuries
🇨🇦 Approved in Canada as ACL Reconstruction for:
- Knee instability due to ACL tear
- Combined ACL and meniscal injuries
- Chronic ACL deficiency
🇯🇵 Approved in Japan as Anterior Cruciate Ligament Reconstruction for:
- Knee instability due to ACL tear
- Combined ACL and meniscal injuries
Find A Clinic Near You
Research locations nearbySelect from list below to view details:
Twin Cities OrthopedicsEdina, MN
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Who is running the clinical trial?
Twin Cities OrthopedicsLead Sponsor
References
Anterior cruciate ligament injuries. Evaluation, arthroscopic reconstruction, and rehabilitation. [2016]The advantages of arthroscopic reconstruction of the anterior cruciate ligament tear over arthrotomy are quite obvious: reduced pain and morbidity. Some arthroscopists are performing these procedures on an outpatient basis. The physician can choose from several graft substitutes for anterior cruciate ligament replacement. Autografts consisting of the iliotibial band, semitendinosus, gracilis, and meniscus have been used as grafts. The most common autograft is the bone-patellar tendon-bone, which has been used since 1930 and has been shown to have a tensile strength near that of the anterior cruciate ligament. The state of the art in surgical alternatives for anterior cruciate ligament tears is arthroscopic reconstruction using the midthird of the patellar tendon. Treatment of anterior cruciate ligament injuries requires prompt and adequate evaluation of the laxity of the ligament as well as other structures in the knee, appropriate treatment options offered to the patient with complete descriptions of knee function after each treatment option, and comprehensive rehabilitation program. Patient compliance is an integral part of the success of this procedure. The nurse must include a description of the injury, preoperative testing, surgical intervention, and rehabilitation program when educating the patient. The successful postoperative anterior cruciate ligament rehabilitation program is multifaceted. In general, there must be specific guidelines applied by a physical therapist who has knowledge of the surgical procedure, understands principles of ligament healing, and has the ability to individualize the program as needed. For any level of athlete or active person, there must be achievement of all goals per phase to a high performance level. In addition, there must always be objective measurements to document progress to the physical therapist and physician but, perhaps most importantly, to reassure the patient that normalcy is being restored.
Rehabilitation of anterior cruciate ligament injuries. [2016]Rehabilitation of the anterior cruciate ligament absent or reconstructed knee is becoming a true artform. Accelerated, but controlled rehabilitation, is becoming more commonplace. Scientific-based data along with clinical experiences are the basis of the rehabilitation guidelines brought forth in this article. Anterior cruciate ligament strain and implications for exercise, continuous passive motion, proprioceptive exercise, and the role of knee bracing are all discussed in relation to the overall rehabilitation program.
Rehabilitation of the multiple-ligament-injured knee. [2022]Rehabilitation for a patient with a multiple-ligament knee injury should be designed to reduce pain and swelling, restore range of motion, strength, and endurance, and to enhance proprioception, and dynamic stability of the knee, with the goals of restoring function and minimizing disability. The biomechanics of the knee must be considered when designing a rehabilitation program. General guidelines for rehabilitation of the multiple-ligament-injured knee include considerations for promoting tissue healing, decreasing pain and swelling, restoring full motion, increasing muscular strength and endurance, improving proprioception, enhancing dynamic stability of the knee, and reducing functional limitations and disability. A patient's progression through this sequence must be individualized and depends on the pattern of ligament injury or surgical procedure that was performed, and the principles of tissue healing. Specific guidelines for rehabilitation following ACL reconstruction combined with MCL repair, PCL reconstruction, combined ACL-PCL reconstruction, and reconstruction of the LCL and posterolateral corner have been provided.
Tibial translation in exercises used early in rehabilitation after anterior cruciate ligament reconstruction exercises to achieve weight-bearing. [2016]Accelerated rehabilitation after ACL reconstruction involves early weight-bearing. Exercises designed to achieve weight-bearing should be effective for the neuromuscular system and protect the knee from excessive anterior tibial translation. The aim of this study was to assess the anterior tibial translation under two different body-weight shift exercises at 2 weeks post-ACL reconstruction and compare this with healthy controls.
Rehabilitation of the knee after anterior cruciate ligament reconstruction. [2019]From the Kerlan-Jobe Orthopaedic Clinic, 501 E. Hardy Street, Suite 200, Inglewood, CA 90301. New information regarding the isometric placement of the anterior cruciate ligament (ACL) substitute, revascularization process, and biomechanical stresses have all contributed to and been incorporated in the rehabilitation program after ACL reconstruction. Treatment protocols specifically designed for the patient following ACL reconstruction are imperative to return the individual to his or her preinjury status. Care is taken to limit the amount of stress placed on the ligament substitute especially at end of range extension. A program incorporating techniques for developing range of motion and strength while still preserving stability at the knee joint is still of the utmost importance. This program is a revision of a previously reported regimen from this facility (Brewster, Moynes, Jobe, J Orthop Sports Phys Ther 5:121-126, 1983) and is based upon clinical experience and research information. J Orthop Sports Phys Ther 1989;11(1):8-18.
Rehabilitation for Patients Following ACL Reconstruction: A Knee Symmetry Model. [2022]This clinical commentary outlines a new clinical model for anterior cruciate ligament (ACL) rehabilitation, the Knee Symmetry Model. This model has been developed by clinical observation, patient interaction, and by analyzing outcome measures derived from prospective follow-up of patients. More specifically, the best outcome scores occurred in patients with symmetric range of motion and strength. A thorough discussion of the details involved in the development and implementation of this rehabilitation program for this patient following ACL reconstruction is described. Included in this description is the supporting evidence and clinical rationale behind pre-operative and post-operative ACL rehabilitation. Preliminary results from a recent group of patients are presented. When using the Knee Symmetry Model 100% of patients achieved normal knee extension and 97% of patients achieved normal knee flexion.
Recent advances following anterior cruciate ligament reconstruction: rehabilitation perspectives : Critical reviews in rehabilitation medicine. [2021]Injuries to the anterior cruciate ligament are common. Surgical reconstruction is more prevalent than ever. This review article discusses treatment of the patient following surgical reconstruction of the anterior cruciate ligament. Various phases of rehabilitation are discussed with emphasis on early return of passive motion, early weight bearing, bracing, kinetic chain exercises, neuromuscular electrical stimulation and accelerated rehabilitation. Although evidence exists for the treatment of the surgically reconstructed cruciate ligament, more is needed to better define specific timeframes for advancement. Evidence exists that many of these young individuals are not fully returning to unlimited high level activities. This review article presents some of the latest evidence regarding anterior cruciate ligament rehabilitation in an attempt to help the busy clinician understand and relate basic and clinical research to rehabilitation of a patient following reconstruction.
Infections in anterior cruciate ligament reconstruction. [2022]Anterior cruciate ligament (ACL) reconstruction is a safe, common, and effective method of restoring stability to the knee after injury, but evolving techniques of reconstruction carry inherent risk. Infection after ACL reconstruction, while rare, carries a high morbidity, potentially resulting in a poor clinical outcome.
Anatomic Fibular Collateral Ligament Reconstruction. [2020]Fibular collateral ligament (FCL) injuries can lead to varus instability of the knee, causing a varus thrust gait and resulting in increased forces on the medial compartment of the knee. In the long term, this can result in meniscal injuries and medial compartment osteoarthritis. Varus instability is also reported to increase forces on the cruciate ligaments, which can lead to overload and failure of these reconstructions in cases of nonrecognized combined injuries. Historically, both repair and reconstruction have been used for grade III injuries to the FCL. However, repair has been reported to lead to a higher reoperation rate. The hereby presented reconstruction technique is used for FCL injuries that do not involve other structures of the posterolateral corner, but can be used in combination with other knee ligament reconstructions including the posterior cruciate ligament, anterior cruciate ligament, and medial collateral ligament. The purpose of this surgical technique article was to describe the biomechanically validated anatomic reconstruction of the FCL using a semitendinosus graft.
Return to National Basketball Association Competition Following Anterior Cruciate Ligament and Fibular Collateral Ligament Injuries: A Case Report. [2022]Numerous outcome studies regarding anterior cruciate ligament (ACL) reconstruction demonstrate the ability of athletes to return to a high level of play. However, to our knowledge, there is limited literature regarding return to play following injury to both the ACL and the fibular collateral ligament (FCL). We describe the case of a National Basketball Association (NBA) player who sustained a combined ACL and FCL knee injury and subsequently underwent surgical reconstruction of both affected ligaments. He was able to return to a preinjury level of competition at 9 months postoperatively.
Partial Controlled Early Postoperative Weightbearing Versus Nonweightbearing After Reconstruction of the Fibular (Lateral) Collateral Ligament: A Randomized Controlled Trial and Equivalence Analysis. [2019]While early weightbearing protocols have been advocated after anterior cruciate ligament (ACL) reconstruction, early weightbearing after fibular (lateral) collateral ligament reconstruction has not been well defined.
Complications After Anterior Cruciate Ligament Reconstruction and Their Relation to the Type of Graft: A Prospective Study of 958 Cases. [2020]Complications and adverse events after anterior cruciate ligament (ACL) reconstruction are well known, but they have been underestimated in previous studies.