Anterior cruciate ligament injury, prophylaxis and surgical reconstruction: A literature review
DOI:
https://doi.org/10.33448/rsd-v13i8.46516Keywords:
Anterior cruciate ligament injury; Prophylaxis; Surgical reconstruction.Abstract
Introduction: Anterior cruciate ligament (ACL) injury is one of the most common and debilitating sports injuries, significantly affecting knee function and patient quality of life. Prophylaxis and surgical reconstruction are essential for effective prevention and treatment of this condition. This article reviews the literature on ACL injury prophylaxis and current surgical reconstruction approaches. Objectives: The objective of this article is to review prophylactic strategies for the prevention of ACL injuries and available surgical reconstruction techniques. The review aims to identify the most effective methods for reducing injury incidence and evaluate best practices for ACL reconstruction, considering factors such as graft choice, rehabilitation protocols, and postoperative outcomes. Results: The analysis revealed that prophylactic programs, including neuromuscular and proprioceptive training, are effective in reducing ACL injury incidence, with recommendations for their implementation in athletes. Regarding surgical reconstruction, comparisons between graft methods, such as patellar tendon and hamstring tendons, showed that using four-strand hamstring tendons provides similar or superior results to patellar tendon, with less morbidity. Intensive rehabilitation protocols, started early, were associated with better functional outcomes and fewer complications. Conclusion: Effective prophylaxis and careful selection of surgical technique are crucial for managing ACL injuries. The combination of well-structured prevention programs and careful choice of reconstruction method, along with an appropriate rehabilitation protocol, can significantly improve clinical outcomes and patient quality of life. Continued research and adoption of evidence-based practices are essential to optimize the treatment and prevention of these injuries.
References
Almeida, A., Valin, M. R., Ferreira, R., Roveda, G., Almeida, N. C. de, & Agostini, A. P. (2010). Avaliação do resultado da reconstrução artroscópica do ligamento cruzado anterior do joelho com enxerto dos tendões flexores. Rev Bras Ortop, 45(4), 404–408. https://doi.org/10.1590/S0102-36162010000400011
Arliani, G. G., Astur, D. da C., Kanas, M., Kaleka, C. C., & Cohen, M. (2012). Lesão do ligamento cruzado anterior: tratamento e reabilitação. Perspectivas e tendências atuais. Rev Bras Ortop, 47(2), 191–196. https://doi.org/10.1590/S0102-36162012000200008
Aryana, I. G. N. W., et al. (2024). Resultado funcional da reconstrução do LCA após habilitação pré-reconstrução vs. nenhuma pré-habilitação: Revisão sistemática e metanálise. Rev Bras Ortop, 59, 172-179. https://doi.org/10.1055/s-0044-1779327.
Boschin, L. C., Schuck, G. F., Oliveira, G., Schmiedt, I., & Schwartsmann, C. R. (2002). Artrotomia "versus" artroscopia: avaliação pós-operatória da reconstrução do ligamento cruzado anterior. Rev Bras Ortop, 37(1/2), 23-30.
Brito, J., Soares, J., & Rebelo, A. N. (2009). Prevenção de lesões do ligamento cruzado anterior em futebolistas. Rev Bras Med Esporte, 15(1), 62–69. https://doi.org/10.1590/S1517-86922009000100014
Filbay, S. R., Ackerman, I. N., Russell, T. G., & Crossley, K. M. (2017). Return to sport matters-longer-term quality of life after ACL reconstruction in people with knee difficulties. Scandinavian Journal of Medicine & Science in Sports, 27(5), 514-524. https://doi.org/10.1111/sms.12698
Grindem, H., Wellsandt, E., Failla, M., Snyder-Mackler, L., & Risberg, M. A. (2018). Anterior cruciate ligament injury—Who succeeds without reconstructive surgery? The Delaware-Oslo ACL Cohort Study. Orthopaedic Journal of Sports Medicine, 6(5), 232596711877425. https://doi.org/10.1177/2325967118774255
Heijne, A., & Werner, S. (2010). A 2-year follow-up of rehabilitation after ACL reconstruction using patellar tendon or hamstring tendon grafts: a prospective randomised outcome study. Knee Surg Sports Traumatol Arthrosc, 18(6), 805-813.
Kay, J., Memon, M., Marx, R. G., Peterson, D., Simunovic, N., & Ayeni, O. R. (2018). Over 90% of children and adolescents return to sport after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surgery, Sports Traumatology, Arthroscopy, 26(4), 1019-1036. https://doi.org/10.1007/s00167-018-4840-2
Lepley, L. K., & Palmieri-Smith, R. M. (2016). Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind randomised trial. Journal of Science and Medicine in Sport, 19(12), 961-967. https://doi.org/10.1016/j.jsams.2016.02.007
Nagelli, C. V., & Hewett, T. E. (2017). Should Return to Sport be Delayed Until 2 Years After Anterior Cruciate Ligament Reconstruction? Biological and Functional Considerations. Sports Medicine, 47(2), 221-232. https://doi.org/10.1007/s40279-016-0584-z
Owoeye, O. B. A., et al. (2014). Efficacy of the FIFA 11+ Warm-Up Programme in Male Youth Football: A Cluster Randomised Controlled Trial. J Sports Sci Med, 13(2), 321-328.
Paterno, M. V., Rauh, M. J., Schmitt, L. C., Ford, K. R., & Hewett, T. E. (2016). Incidence of Second ACL Injuries 2 Years After Primary ACL Reconstruction and Return to Sport. The American Journal of Sports Medicine, 44(7), 1886-1891. https://doi.org/10.1177/0363546515621554
Pereira, M., Vieira, N. S., Brandão, E. R., Ruaro, J. A., Grignet, R. J., & Fréz, A. R. (2012). Tratamento fisioterapêutico após reconstrução do ligamento cruzado anterior. Acta Ortop Bras, 20(6), 372–375. https://doi.org/10.1590/S1413-78522012000600011
Sabat, D., & Kumar, V. (2013). Nerve injury during hamstring graft harvest: a prospective comparative study of three different incisions. Knee Surg Sports Traumatol Arthrosc, 21(9), 2089–2095.
Silva, K. N. G., Imoto, A. M., Cohen, M., & Peccin, M. S. (2010). Reabilitação pós-operatória dos ligamentos cruzado anterior e posterior: estudo de caso. Acta Ortop Bras, 18(3), 166–169. https://doi.org/10.1590/S1413-78522010000300010
Souza, R. M., Tiburcio, A. M., Claudio, A. C. J., Micheletti, J. K., & Menossi, B. R. S. (2023). Do final rehabilitation volumes influence function after anterior cross ligament reconstruction? A pilot study. Fisioterapia Em Movimento, 36.
Webster, K. E., & Hewett, T. E. (2018). Meta-analysis of meta-analyses of anterior cruciate ligament injury reduction training programs. Journal of Orthopaedic Research, 36(10), 2696-2708. https://doi.org/10.1002/jor.24043
Wiggins, A. J., Grandhi, R. K., Schneider, D. K., Stanfield, D., Webster, K. E., & Myer, G. D. (2016). Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine, 44(7), 1861-1876. https://doi.org/10.1177/0363546515621550
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Luis Miguel Carvalho Mendes; Lucas Arruda Lino; Ana Beatriz Castelo Branco Ribeiro; Claodionor Antonio de Oliveira Amorim Neto; Lucas Carvalho Mendes; Carlos Henrique Aires Magalhães Seixas; Rayane Cavenage Silva; Victória Araujo Oliveira; Ana Laura Azevedo Rezende; Pablo de Souza Barp; Arthur Teixeira Guimarães; Kallyne Rodrigues de Oliveira
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.