Andrew D Lynch1, Terese Chmielewski2, Lane Bailey3, Michael Stuart4, Jonathan Cooper5, Cathy Coady6, Terrance Sgroi7, Johnny Owens8, Robert Schenck9, Daniel Whelan10, Volker Musahl11, James Irrgang11. 1. University of Pittsburgh, 100 Technology Drive, Pittsburgh, PA, 15219, USA. Adl45@pitt.edu. 2. TRIA Orthopaedic Center, Minneapolis, MN, USA. 3. University of Texas at Houston, Houston, TX, USA. 4. Mayo Clinic, Rochester, MN, USA. 5. HealthPartners Institute, St. Paul, MN, USA. 6. Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. 7. Hospital for Special Surgery, New York, NY, USA. 8. San Antonio Military Medical Center, San Antonio, TX, USA. 9. University of New Mexico, Albuquerque, NM, USA. 10. St. Michael's Hospital, Toronto, Ontario, Canada. 11. University of Pittsburgh, 100 Technology Drive, Pittsburgh, PA, 15219, USA.
Abstract
PURPOSE OF REVIEW: The purpose of this manuscript is twofold: (1) to review the literature related to rehabilitation after surgery for multiple ligament knee injury (MLKI) and after isolated surgery for the posterior cruciate ligament (PCL), posterolateral corner (PLC), and medial side of the knee and (2) to present a hierarchy of anatomic structures needing the most protection to guide rehabilitation. RECENT FINDINGS: MLKIs continue to be a rare but devastating injury. Recent evidence indicates that clinicians may be providing too much protection from early weight bearing and range of motion, but an accelerated approach has not been rigorously tested. Consideration of the nature and quality of surgical procedures (repair and reconstruction) can help clinicians determine the structures needing the most protection during the rehabilitation period. The biomechanical literature and prior clinical experience can aid clinicians to better structure rehabilitation after surgery for MLKI and improve clinical outcome for patients.
PURPOSE OF REVIEW: The purpose of this manuscript is twofold: (1) to review the literature related to rehabilitation after surgery for multiple ligament knee injury (MLKI) and after isolated surgery for the posterior cruciate ligament (PCL), posterolateral corner (PLC), and medial side of the knee and (2) to present a hierarchy of anatomic structures needing the most protection to guide rehabilitation. RECENT FINDINGS: MLKIs continue to be a rare but devastating injury. Recent evidence indicates that clinicians may be providing too much protection from early weight bearing and range of motion, but an accelerated approach has not been rigorously tested. Consideration of the nature and quality of surgical procedures (repair and reconstruction) can help clinicians determine the structures needing the most protection during the rehabilitation period. The biomechanical literature and prior clinical experience can aid clinicians to better structure rehabilitation after surgery for MLKI and improve clinical outcome for patients.
Entities:
Keywords:
Early range of motion; Early weight bearing; Knee dislocation; Multiple ligament knee injury; Post-surgical rehabilitation
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