In the previous article (see below) we discussed the MACI procedure including a rough guideline for physiotherapy rehabilitation following the surgery. In this article we will expand on this idea and discuss the mid-term outcomes of the surgery, including that which we are all interested in; return to play outcomes.
In the world of sports physiotherapy and sports medicine articular cartilage defects of the knee are commonly seen (Reinold et al., 2006). Unfortunately, in these cases we find non-operative approaches are ineffective given the avascular nature of articular cartilage. Thus, there has been the development of a large number of surgical techniques to address articular cartilage lesions. This article will discuss a relatively new technique, Matrix-induced autologous cartilage implantation or MACI, including an overview of technique, mid-term outcomes and of course the rehabilitation implications for physiotherapists.
To explain the importance of knowledge about these conditions I will frequently tell you how common these ligament injuries are. Well, it has been suggested that up to 37% of all patients with knee haemarthroses have an associated PCL injury. Furthermore, the incidence of injury is particularly high in sports that involve heavy contact. That means that sports physiotherapists that are involved in the management of athletes from contact sports need to be aware of the evidence based assessment and management of these ligament injuries.
The majority of the sports physiotherapists reading this will know the incredible frequency with which we treat athletes with patellofemoral pain syndrome. There is a good reason for this, it is the most commonly reported injury sustained by runners (Taunton et al., 2002). Whilst the mainstays of treatment have previously focussed solely on the patellofemoral joint, we are seeing more research identifying the importance of the assessing the other components of the kinetic chain.This article will discuss new research on the impact of real time gait retraining for patellofemoral pain syndrome…
Introduction Sports physiotherapists will regularly (I’m talking every day) rehabilitate knees that have undergone ACL reconstruction. As the vast majority of you will know, it is a common injury with a relatively long rehabilitation timeframe (generally 6 – 12 months depending on surgeon’s preference). This long rehabilitation and progression through to return to play (RTP) […]
Patellar dislocation accounts for 2 – 3% of all knee injuries, however, is the second most common cause of knee haemarthrosis (Aglietti et al., 2001). Patellar dislocation is most commonly associated with sports injuries, and therefore, is encountered commonly by the sports physiotherapist. In recent times there has been controversy on the most appropriate forms of management following primary (or first time) patellar dislocation. This post discusses evidence based management of primary patellar dislocations.
Hamstring injuries are an extremely common sporting injury. Hawkins et al. (2001) showed that hamstring injuries accounted for approximately 12% of football injuries. In certain sports, such as Australian Football, hamstring injuries have the highest incidence of any injury (Warren et al., 2010). This means that many teams, and their sports physiotherapists, invest massive amounts of time and energy in hamstring injury prevention. This is clearly based on the adage that ‘prevention is better than cure’. So what can we do to prevent hamstring injuries??
Cyclops lesions are an unfortunate sequelae of anterior cruciate ligament injury, and are most commonly seen following ACL reconstructions. The cyclops lesion is a consequence of a localised form of anterior arthrofibrosis. This results in the formation of a nodule of fibrous tissue in the anterior portion of the ACL graft (Tonin et al., 2001). The cyclops lesion sits in the anterior margin of the intercondylar notch, just above the tibial tunnel, which can become impinged between the tibia and femur upon knee extension (Bradley et al., 2000).
Patellar tendinopathy, commonly referred to as “Jumper’s Knee”, is a common overuse lower limb injury. In certain sporting populations, such as elite volleyball, the incidence can be as high as 45% (Lian et al., 2005). Thus, it is easy to see the importance of the identification of risk factors for patellar tendinopathy. Additionally, once identified such risk factors have clear implications for both the prevention and rehabilitation of this condition. This article discusses the latest research identifying risk factors for the development of patellar tendinopathy.
The sports physiotherapist will frequently assess and diagnose acute knee injuries. In doing so, we will regularly rely on the results of special orthopaedic or clinical tests. However, if we are going to use these tests to make diagnoses and therefore guide our treatment decisions, it is vital that we are aware of the diagnostic accuracy of clinical tests. This article evaluates the research regarding the diagnostic accuracy of commonly used clinical tests for medial meniscus tears.