Weightbearing Strategies After Knee Ligament Surgery for Knee Injuries
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
Approved in 1 jurisdiction
Trial Summary
What is the purpose of this trial?This is a prospective randomized controlled trial with the purpose to determine if patients undergoing isolated posterior cruciate ligament (PCL) reconstruction, or isolated medial collateral ligament (MCL) reconstruction, or combined PCL, anterior cruciate ligament (ACL), fibular collateral ligament (FCL), posterolateral corner (PLC), and MCL reconstructions (or any combination of multiple ligaments) can safely begin partial controlled weightbearing for the first six weeks after surgery.
What data supports the effectiveness of this treatment for knee injuries?
Research suggests that a structured physical therapy program after knee ligament surgery can lead to successful outcomes, even with a limited number of therapy visits. Additionally, for young and healthy individuals, home exercise programs can be as effective as supervised physical therapy for simple knee surgeries.
468910Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
How is the treatment of physical therapy unique for knee ligament surgery recovery?
Physical therapy for knee ligament surgery recovery is unique because it involves a structured program that gradually increases joint mobility and muscle strength, while also incorporating techniques like proprioceptive exercises, electrical stimulation, and isokinetic training to enhance recovery. This approach is tailored to avoid complications like ligament slackening and stagnating mobility, making it distinct from unsupervised home exercises.
123611Eligibility Criteria
This trial is for individuals aged between 14 and 60 who have had surgery to repair a knee ligament injury, such as the PCL alone or in combination with other ligaments like ACL and MCL. Participants must be able to follow the study plan and give informed consent. It's not open to those with certain concurrent surgeries, previous vascular injuries, pregnant women, or anyone needing revision PCL reconstructions.Inclusion Criteria
I have had surgery to repair both my ACL and MCL.
I am having surgery to reconstruct my PCL only.
I am having surgery to reconstruct my MCL only.
I am between 14 and 59 years old.
I had surgery to repair multiple torn ligaments in my knee.
Exclusion Criteria
I have had a vascular bypass procedure.
I am under 14 years old.
I am over 60 years old.
I need surgery for fractures related to my condition.
I am having or have had a revision of my PCL surgery.
I am having surgery to repair a knee injury.
Participant Groups
The study is testing whether patients can safely start partial controlled weightbearing during the first six weeks after reconstructive knee surgery. This involves comparing two approaches: non-weightbearing versus partial weightbearing post-surgery through randomized assignment of participants.
2Treatment groups
Experimental Treatment
Active Control
Group I: Partial weight -bearing for the first six weeks after surgeryExperimental Treatment1 Intervention
Partial weightbearing will be defined as 40% of the patient's body weight.
Group II: Non-weightbearing for the first six weeks after surgeryActive Control1 Intervention
Not weightbearing after surgery
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
[Early complications, concomitant and follow-up treatment of fresh combined knee ligament injuries]. [2008]A graduated, concomitant and follow-up treatment of fresh knee-joint ligament injuries helps to reduce pain, restore mobility and increase muscular strength. By slowly increasing joint mobility, secondary ligament slackening is avoided. Likewise static loading should be increased gradually. Physiotherapeutic exercise techniques to restore proprioceptive ligamentous control mechanisms as well as transcutaneous electrical neurohpysiological stimulation, ice treatment, ultrasound and isokinetic training techniques support these measures. Early complications include infection and stagnating mobility despite intensive exercise treatment. Both require consistent, purposeful action.
[After-care in surgical replacement of the ligaments of the knee joint]. [2008]Reconstructive surgery of ligamentous injuries of the Knee Joint is often associated with a considerable impairment of its integrity and requires a high standard of surgical technique. The postoperative course, aiming towards normal function, is demanding and bound to biomechanical and biological principles. It therefore has to be built up gradually and lasts basically 12 months - with an individual variety. Up to the 6th postoperative week the healing process is in the foreground. During the second phase, up to the 12th week careful rehabilitation is aimed to improve muscle strength, increase weight bearing and optimize mobility. In the third phase, from the 12th week on, the patient regains full strength, range of motion as well as coordination, and an integrated sport rehabilitation is started.
[Treatment of new knee joint ligament injuries in the regional hospital]. [2006]In the years from 1975 to 1978 we have treated 57 cases of injury to the knee ligaments. Therapeutic procedures, indication for operation and results are discussed in this paper. Intensive physiotherapy is of great importance in the postoperative period.
The effects of the number and frequency of physical therapy treatments on selected outcomes of treatment in patients with anterior cruciate ligament reconstruction. [2022]Health care reform will quite possibly change the delivery of physical therapy by demanding physical therapists to be more accountable for providing appropriate, yet cost-effective treatment. The purpose of this study was to retrospectively compare the results after anterior cruciate ligament (ACL) reconstruction between two groups of patients with different numbers and frequencies of physical therapy visits postoperatively. Two random samples of 100 patients from a total of 1,345 patients identified as undergoing ACL reconstruction from 1990 through 1993 were included. Group A patients attended physical therapy regularly and participated in a home exercise program, while patients in Group B attended limited physical therapy visits and also performed a prescribed home exercise program. Both groups followed the same postoperative rehabilitation program for early range of motion, early weight bearing, and muscle control. The outcome variables measured 1, 6, and 12 months postoperatively included the number of structured visits to physical therapy, range of motion, isokinetic strength testing, and subjective rating. Group A averaged 20 visits in the first 6 months while Group B averaged seven visits. The results revealed no significant difference for flexion, isokinetic strength, or subjective rating. There was a significant difference for hyperextension (Group A, 2 degrees; Group B, 6 degrees). The results of this investigation indicated that by following a structured physical therapy program postoperatively, it is possible for patients to achieve a successful outcome with a limited number of routine physical therapy visits.
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.
Is physical therapy more beneficial than unsupervised home exercise in treatment of post surgical knee disorders? A systematic review. [2022]Physical therapy is common following a knee surgery. With rising healthcare costs there is debate as to the appropriateness of outpatient physical therapy following such interventions. Many of the existing controlled trials have concluded that there is no benefit to subjects that receive supervised physical therapy when compared to subjects that perform their exercises at home. The purpose of this systematic review was to consider the existing evidence regarding benefit following knee surgery and evaluate the quality, internal and external validity of such evidence. Ten studies, all randomized control trials, were found to be applicable to our review. Using the PEDro scale all studies were considered at least moderate in quality. Many of the studies had designs that biased the home exercise group, providing supervision similar to that provided by outpatient physical therapy. In select young and healthy population with few co morbidities supervised physical therapy is no more beneficial than a home exercise program following relatively simple knee surgical procedures (arthroscopic meniscetomy). However there is a lack of evidence regarding older populations with co morbidities or for more complicated knee surgical procedures (ACL reconstruction, Total Knee Arthroplasty) prohibiting a conclusion at this time for these populations and/or these procedures.
A perioperative rehabilitation program for anterior cruciate ligament surgery. [2010]Rehabilitation programs have progressed alongside surgical advances in anterior cruciate ligament reconstruction. A perioperative program has been successfully used at our clinic for more than 10 years to reduce postoperative complications and return patients to activity safely and quickly. The four-phase program starts at the time of injury and preoperatively includes aggressive swelling reduction, hyperextension exercises, gait training, and mental preparation. Goals after surgery are to control swelling while regaining full knee range of motion. After quadriceps strengthening goals are reached, patients can shift to sport-specific exercises.
Outcome of surgical treatment of arthrofibrosis following ligament reconstruction. [2021]Clinical outcome following surgical treatment and intensive physiotherapy was evaluated in patients with arthrofibrosis as a complication to varying knee-ligament reconstructions.
Cognitive-behavioral-based physical therapy to enhance return to sport after anterior cruciate ligament reconstruction: An open pilot study. [2020]To describe feasibility, adherence, acceptability, and outcomes of a cognitive-behavioral-based physical therapy (CBPT-ACLR) intervention for improving postoperative recovery after anterior cruciate ligament reconstruction (ACLR).
Neuromuscular Training following Anterior Cruciate Ligament reconstruction - Pain, Function, Strength, Power & Quality of Life Perspective: A Randomized Control Trial. [2022]To determine the effectiveness of neuromuscular physical Therapy as compared to strength training following anterior cruciate ligament reconstruction in terms of pain, function, quality of life, strength and power of participants.
ACL Reconstruction: Which Additional Physiotherapy Interventions Improve Early-Stage Rehabilitation? A Systematic Review. [2022]Despite the restoration of the mechanical stability of the knee joint after ACL reconstruction (ACLR), patients often experience postoperative limitations. To our knowledge, there are no systematic reviews analyzing additional physiotherapy interventions implementing standard rehabilitation programs in the early postoperative phase after ACLR. The objective of this study was to analyze the additional physiotherapy interventions implemented in standard rehabilitation programs that improve early-stage ACLR rehabilitation. For this systematic review, we followed the PRISMA guidelines. In March 2022 we conducted a literature review using electronic databases. Primary outcomes were pain, edema, muscle strength, ROM, and knee function. The risk of bias and scientific quality of included studies were assessed with the RoB 2, ROBINS-I and PEDro scale. For the review, we included 10 studies that met the inclusion criteria (total n = 3271). The included studies evaluated the effectiveness of Kinesio Taping, Whole-body vibration, Local Vibration Training, Trigger Point Dry Needling, High Tone Power Therapy, alternating magnetic field, and App-Based Active Muscle Training Program. Most of the additional physiotherapy interventions improved pain, edema, ROM, knee muscle strength, or knee function in early-stage postoperative ACL rehabilitation. Except for one study, no adverse events occurred in the included studies, which demonstrates the safety of the discussed physiotherapy interventions. Further in-depth research is needed in this area.