Haack Colten, Zeppieri Giorgio, Moser Micheal W
Department of Sports Medicine University of Wisconsin Health.
Department of Rehabilitation University of Florida Health.
Int J Sports Phys Ther. 2024 Jun 1;19(6):745-757. doi: 10.26603/001c.117773. eCollection 2024.
Anterior Cruciate Ligament (ACL) injuries continue to be a major source of morbidity in gymnastics. The gold standard is to perform an ACL Reconstruction (ACLR). However, injuries to the proximal femoral attachment of the ACL have demonstrated an ability to regenerate. An alternative surgical intervention to the ACLR in this ACL tear subgroup is an ACL repair. The purpose of this case report is to provide a rehabilitation progression for a female gymnast after an ACL repair with Internal Brace Ligament Augmentation (IBLA).
The subject was a 16-year-old female who presented with a Sherman Type 1 proximal avulsion of her ACL. She underwent an ACL repair with IBLA. Physical therapy interventions followed a sequential and multi-phased approach based on time for tissue physiologic healing and individual progression. Patient reported outcomes including the International Knee Documentation Committee (IKDC), the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) were assessed in conjunction with isokinetic strength and hop performance testing to determine return to sport readiness.
The subject completed 42 sessions over the course of 26 weeks in addition to a home exercise program. At return to sport, clinically meaningful improvement was observed in patient reported outcomes including the IKDC, ACL-RSI, and OSPRO-YF. Additionally, strength and hop performance surpassed established thresholds of clinical significance. The subject returned to sport at six months post-operatively.
The subject in this case report returned to full participation in gymnastics six months after an ACL repair with internal bracing following a sequential and multi-phased rehabilitation. The primary ACL repair with IBLA appeared beneficial to this patient and could benefit from additional study in other athletes and athletic populations.
Level 5.
前交叉韧带（ACL）损伤仍是体操运动中发病的主要原因。金标准治疗方法是进行ACL重建术（ACLR）。然而，ACL在股骨近端附着点的损伤已显示出具有再生能力。对于ACL撕裂亚组的患者，ACLR的一种替代手术干预方法是ACL修复术。本病例报告的目的是为一名接受了带内部支撑韧带增强术（IBLA）的ACL修复术的女性体操运动员提供康复进展情况。
该患者为一名16岁女性，出现Sherman 1型ACL近端撕脱伤。她接受了带IBLA的ACL修复术。物理治疗干预基于组织生理愈合时间和个体进展情况，采用循序渐进、多阶段的方法。结合等速肌力测试和单腿跳测试，评估了患者报告的结果，包括国际膝关节文献委员会（IKDC）评分、ACL损伤后恢复运动（ACL-RSI）评分以及预测转诊和结果黄旗的最佳筛查（OSPRO-YF）评分，以确定其恢复运动的准备情况。
除家庭锻炼计划外，该患者在26周内共完成了42次治疗。在恢复运动时，观察到患者报告的结果有临床意义的改善，包括IKDC、ACL-RSI和OSPRO-YF评分。此外，力量和单腿跳表现超过了既定的临床意义阈值。该患者在术后6个月恢复运动。
本病例报告中的患者在接受带内部支撑的ACL修复术后，经过循序渐进、多阶段的康复，在6个月后恢复了全面的体操运动。带IBLA的原发性ACL修复术对该患者似乎有益，并且可能在其他运动员和运动人群中通过更多研究而受益。
5级。
