Postoperative considerations based on graft type after anterior cruciate ligament reconstruction a narrative review.

Autor:	Leung A; Department of Physical Therapy, Arcadia University, Glenside, PA, USA., DeSandis B; Good Sheppard Penn Partners, Glenside, PA, USA., O'Brien L; Milwaukee Bucks, Milwaukee, WI, USA., Hammoud S; Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Rothman Institute, Philadelphia, PA, USA., Zarzycki R; Department of Physical Therapy, Arcadia University, Glenside, PA, USA.
Jazyk:	angličtina
Zdroj:	Annals of joint [Ann Jt] 2023 Jun 25; Vol. 8, pp. 26. Date of Electronic Publication: 2023 Jun 25 (Print Publication: 2023).
DOI:	10.21037/aoj-22-51
Abstrakt:	Background and Objective: Graft selection for anterior cruciate ligament reconstruction (ACLR) affects rehabilitation throughout the course of postoperative care. Methods: A search of PubMed and EBSCO was performed and abstracts independently reviewed by two authors. This search was also supplemented with additional evidence relevant to each phase of ACLR rehabilitation. Key Content and Findings: Direct implications of graft type on clinical decisions vary throughout treatment phases, transitioning from potential differences in acute postoperative pain management immediately after surgery to facilitating sufficient and appropriate lower extremity loading in subsequent weeks. Regardless of graft type, surgical limb weakness persists throughout the course of rehabilitation; however, harvest site selection for autografts contributes to disproportionate weakness of the harvested muscle group and the potential for surgical-induced tendinopathy. In later phases of rehabilitation, as athletes are transitioning into return to sport (RTS), treatment decisions and protocols are less affected by graft type but expectations for meeting clinical milestones and the time required to do so does differ between graft types. Conclusions: Targeted strengthening interventions to address muscle weakness following graft harvest in autografts should be continued throughout the rehabilitation process. Lingering deficits in quadriceps strength symmetry may also influence time to meet progression and RTS criteria following graft harvest from the extensor mechanism. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aoj.amegroups.org/article/view/10.21037/aoj-22-51/coif). The series “Implications of Graft Choice in ACL Reconstruction” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare. (2023 Annals of Joint. All rights reserved.)
Databáze:	MEDLINE
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