A 10-year prospective trial of a patient management algorithm and screening examination for highly active individuals with anterior cruciate ligament injury: Part 1, outcomes.

BACKGROUND: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture. OBJECTIVE: To prospectively characterize and cla...

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Publicado en:American Journal of Sports Medicine Vol. 36; no. 1; pp. 40 - 48
Autores principales: Hurd WJ, Axe MJ, Snyder-Mackler L
Formato: clinical trial research Journal Article
Publicado: Sage Publications Inc. Jan2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2008
      vid: 36
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/0363546507308190
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        atl: A 10-year prospective trial of a patient management algorithm and screening examination for highly active individuals with anterior cruciate ligament injury: Part 1, outcomes.
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        au:
          Hurd WJ
          Axe MJ
          Snyder-Mackler L
        affil: Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA.
      sug:
        subj:
          Anterior Cruciate Ligament Injuries
          Knee Injuries Therapy
          Adolescence
          Adult
          Algorithms
          Anterior Cruciate Ligament Physiology
          Clinical Trials
          Decision Making
          Female
          Knee Injuries Classification
          Knee Injuries Rehabilitation
          Male
          Middle Age
          Physical Examination
          Prospective Studies
          Recovery Physiology
          Treatment Outcomes
          Human
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: BACKGROUND: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture. OBJECTIVE: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care. METHODS: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care. RESULTS: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up. CONCLUSION: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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