دورية أكاديمية
Isokinetic Strength Deficit 6 Months After Adductor Canal Blockade for Anterior Cruciate Ligament Reconstruction.
| العنوان: | Isokinetic Strength Deficit 6 Months After Adductor Canal Blockade for Anterior Cruciate Ligament Reconstruction. |
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| المؤلفون: | Christensen JE; Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA., Taylor NE; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA., Hetzel SJ; Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA., Shepler JA; Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA., Scerpella TA; Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA. |
| المصدر: | Orthopaedic journal of sports medicine [Orthop J Sports Med] 2017 Nov 08; Vol. 5 (11), pp. 2325967117736249. Date of Electronic Publication: 2017 Nov 08 (Print Publication: 2017). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage on behalf of: The American Orthopaedic Society for Sports Medicine Country of Publication: United States NLM ID: 101620522 Publication Model: eCollection Cited Medium: Print ISSN: 2325-9671 (Print) Linking ISSN: 23259671 NLM ISO Abbreviation: Orthop J Sports Med Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Thousand Oaks, CA] : Sage on behalf of: The American Orthopaedic Society for Sports Medicine, [2013]- |
| مستخلص: | Background: Recent evidence shows a delayed return to sport in children and delayed quadriceps recovery in both adults and children who have undergone anterior cruciate ligament (ACL) reconstruction with concomitant femoral nerve blockade (FNB) compared with those who had no blockade. We evaluated the use of adductor canal blockade (ACB), as an alternative to FNB, at the time of ACL reconstruction. Hypothesis: Patients who receive ACB will have greater isokinetic strength at 6 months postoperative compared with patients who receive FNB at the time of ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective record review was performed at a single academic medical center to identify all patients aged ≥16 years who had undergone ACL reconstruction with blockade between January 2010 and January 2015. Exclusion criteria included (1) non-sports medicine fellowship-trained surgeon performing the procedure, (2) continuous nerve catheter or concurrent epidural used, (3) revision ACL reconstruction or multiligament reconstruction as the index procedure, (4) previous contralateral ACL reconstruction, (5) concurrent microfracture, and (6) additional surgery within the 6-month outcome period that affected recovery. Isokinetic strength testing was performed using a computerized dynamometer, measuring total work at fast speed and peak torque at slow speed at 6 months; results were evaluated as a percentage of the nonoperative side. Multivariate regression analysis was used to evaluate the effect of block type on isokinetic strength outcome variables, controlling for age, sex, body mass index, graft type, and surgeon. Results: There were 230 patients receiving FNB and 30 patients receiving ACB included in the study. The multivariate regression analysis identified a greater side-to-side deficit in extension total work for the ACB group compared with the FNB group ( P = .040), after controlling for age, sex, body mass index, graft type, and surgeon. Conclusion: Compared with FNB, ACB for ACL reconstruction is associated with a persistent fast-activation isokinetic strength deficit at 6 months after surgery. This is the first study to compare FNB to ACB, and results are concerning for patients planning an early return to sport. Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. |
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| فهرسة مساهمة: | Keywords: ACL; anesthesia/pain management; clinical assessment/grading scales; knee; knee ligaments; muscle physiology |
| تواريخ الأحداث: | Date Created: 20171121 Latest Revision: 20220310 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC5680944 |
| DOI: | 10.1177/2325967117736249 |
| PMID: | 29152521 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2325-9671 |
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| DOI: | 10.1177/2325967117736249 |