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Which patients need anterior cruciate ligament reconstruction after initial treatment with rehabilitation? A scoping review

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Název: Which patients need anterior cruciate ligament reconstruction after initial treatment with rehabilitation? A scoping review
Autoři: Arp, Kamilla, Nedermark, Jacob, Ingwersen, Kim Gordon, Ageberg, Eva, Varnum, Claus, Viberg, Bjarke
Přispěvatelé: Lund University, Faculty of Medicine, Department of Health Sciences, Sport Sciences, Lunds universitet, Medicinska fakulteten, Institutionen för hälsovetenskaper, Idrottsvetenskap, Originator, Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator
Zdroj: Knee Surgery, Sports Traumatology, Arthroscopy. 33(2):500-512
Témata: Medical and Health Sciences, Health Sciences, Physiotherapy, Medicin och hälsovetenskap, Hälsovetenskap, Fysioterapi
Popis: Purpose: Some patients with anterior cruciate ligament (ACL) injury initially treated with rehabilitation need ACL reconstruction (ACLR); yet, it is unclear what characterizes these patients. This review aimed to describe predictors for ACLR in patients initially treated with rehabilitation. Methods: A systematic literature search was performed in the Cochrane, Embase, Medline, SportsDiscus and Web of Science databases from inception to 21 February 2023. Articles describing characteristics in adult patients with ACL injury undergoing ACLR after a minimum of 5 weeks rehabilitation were included. It was a priori chosen that characteristics described in at least three articles were considered more certain and could be defined as a predictor for ACLR, and those described in less than three articles were considered less certain and therefore defined as possible predictors. Articles were screened by two independent reviewers. The study was originally intended as a systematic review with meta-analysis, but in case of limited data, we would convert it to a scoping review, as was the case for this review. Results: There were 22,836 studies identified, and 181 full texts were screened, of which 10 papers were finally included. Only lower age and higher preinjury activity level were identified as predictors for ACLR. Another 12 possible predictors were identified in single studies. Through an iterative process, potential predictors were categorized into four groups: patient demographics, knee function, patient-reported outcome measures and anatomical structures. Conclusion: Lower age and higher preinjury activity level were the only predictors for ACLR after initial treatment with rehabilitation. While younger and highly active patients show a higher need for ACLR, more studies focussing on predictors and reasons for delayed ACLR are warranted. Level of Evidence: Level II.
Přístupová URL adresa: https://doi.org/10.1002/ksa.12378
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  Data: Which patients need anterior cruciate ligament reconstruction after initial treatment with rehabilitation? A scoping review
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  Data: Lund University, Faculty of Medicine, Department of Health Sciences, Sport Sciences, Lunds universitet, Medicinska fakulteten, Institutionen för hälsovetenskaper, Idrottsvetenskap, Originator<br />Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator
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  Data: <i>Knee Surgery, Sports Traumatology, Arthroscopy</i>. 33(2):500-512
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  Data: Purpose: Some patients with anterior cruciate ligament (ACL) injury initially treated with rehabilitation need ACL reconstruction (ACLR); yet, it is unclear what characterizes these patients. This review aimed to describe predictors for ACLR in patients initially treated with rehabilitation. Methods: A systematic literature search was performed in the Cochrane, Embase, Medline, SportsDiscus and Web of Science databases from inception to 21 February 2023. Articles describing characteristics in adult patients with ACL injury undergoing ACLR after a minimum of 5 weeks rehabilitation were included. It was a priori chosen that characteristics described in at least three articles were considered more certain and could be defined as a predictor for ACLR, and those described in less than three articles were considered less certain and therefore defined as possible predictors. Articles were screened by two independent reviewers. The study was originally intended as a systematic review with meta-analysis, but in case of limited data, we would convert it to a scoping review, as was the case for this review. Results: There were 22,836 studies identified, and 181 full texts were screened, of which 10 papers were finally included. Only lower age and higher preinjury activity level were identified as predictors for ACLR. Another 12 possible predictors were identified in single studies. Through an iterative process, potential predictors were categorized into four groups: patient demographics, knee function, patient-reported outcome measures and anatomical structures. Conclusion: Lower age and higher preinjury activity level were the only predictors for ACLR after initial treatment with rehabilitation. While younger and highly active patients show a higher need for ACLR, more studies focussing on predictors and reasons for delayed ACLR are warranted. Level of Evidence: Level II.
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