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Showing 1-20 of 37 trials
NCT06819696
This is a prospective randomized study comparing tourniquet use versus a dual-flow arthroscopy sheath in Anterior Cruciate Ligament (ACL) reconstruction surgery. The ACL is largely responsible for knee stability and contributes to central pivot with the posterior cruciate ligament. ACL rupture is associated with a violent twisting motion of the knee, which is usually irreparable without surgical intervention. ACL reconstruction via arthroscopy is the gold standard treatment for young, active patients with knee instability. Reconstruction is commonly performed using a thigh tourniquet to improve intraoperative visibility, reduce bleeding, and shorten procedure time. However, numerous studies associate tourniquet use with an increased risk of postoperative complications such as increased pain, muscle injury, postoperative bleeding, and deep vein thrombosis. Therefore, it seems relevant to conduct further investigations into the benefits of new methods to replace tourniquet. In this context, the dual-flow arthroscopy sheath could improve postoperative recovery after ACL reconstruction and could limit the risk of complications, thus improving ambulatory care for patients. This study propose to compare two groups of patients undergoing ACL reconstruction: those operated on with a tourniquet versus those operated on using the dual-flow arthroscopy sheath.
NCT07485530
This three-year research project aims to test the hypothesis that strain and displacement characteristics of human soft tissues are influenced by (1) habitual physical activity, (2) functional impairment, and (3) training interventions. Over the three years, the ulnar collateral ligament of the elbow, the ankle tendon, and the hamstring muscles will be investigated sequentially. Ultrasound speckle-tracking techniques will be employed to verify these hypotheses and to provide a basis for clinical risk assessment of injury, development of therapeutic strategies, and evaluation of rehabilitation outcomes. In the first year, strain and displacement of the medial ulnar collateral ligament (MUCL) in both longitudinal and transverse directions during passive isokinetic elbow valgus loading will be analyzed in baseball pitchers at high and low injury risk and in healthy controls. The results will be compared with ultrasonic shear-wave elastography. Participants will then undergo an 8-week low- to moderate-intensity blood-flow restriction resistance training program. This phase is expected to characterize ligament mechanical adaptations to long-term sports training, elucidate the relationship between such adaptations and injury risk, and evaluate the effects of resistance training on enhancing medial elbow joint stability. In the second year, individuals with posterior tibial tendon dysfunction and healthy controls will be examined. Longitudinal strain and displacement, as well as transverse rotation and displacement of the tibialis posterior tendon during active ankle movements will be quantified and compared with shear-wave elastography measurements. These results are expected to clarify the relationship between tendon strain-displacement behavior and tendon dysfunction, provide mechanistic insights into tendon pathology, and inform optimal therapeutic strategies. In the third year, patients following anterior cruciate ligament (ACL) reconstruction will be investigated. Longitudinal strain and displacement of the hamstring graft donor site, specifically the semitendinosus muscle-tendon unit, following eccentric training will be assessed and compared with shear-wave elastography and electromyography. This phase is expected to characterize post-harvest semitendinosus muscle activity patterns and their associations with postoperative muscle strength deficits. By integrating findings across the three phases, the anticipated clinical implications of this project include determining whether: 1. adaptive responses of ligaments to repetitive tensile loading during long-term sports participation (including strain behavior and mechanical properties) can serve as screening indicators for injury risk, and evaluating the effects of blood-flow restriction resistance training in these populations; 2. three-dimensional strain, displacement, and rotation of tendons in response to muscle contraction and joint motion are associated with tendon dysfunction; and 3. strain and displacement characteristics of the semitendinosus muscle (in relation to muscle recruitment) can be improved through postoperative functional training following its use as a graft source.
NCT06762392
The goal of this clinical trial is to evaluate the effectiveness of adding Blood Flow Restriction (BFR) therapy to a standardized rehabilitation protocol in patients undergoing postoperative rehabilitation following anterior cruciate ligament (ACL) repair surgery. The main questions it aims to answer are: Does combining BFR therapy with a standardized rehabilitation protocol improve functional recovery compared to rehabilitation alone? Does the addition of BFR therapy enhance muscle strength and reduce recovery time in patients after ACL repair surgery? Participants will undergo their assigned rehabilitation protocol and will be assessed prior to and after the intervention to determine if the addition of BFR therapy to the standard rehabilitation programme significantly improves functional recovery, muscle strength, and overall rehabilitation outcomes following ACL repair surgery.
NCT07448064
Purpose: This study aims to better understand how force is produced during a vertical jump in individuals approximately six months after anterior cruciate ligament reconstruction compared with healthy individuals. After this type of knee surgery, many patients recover well clinically but may still present strength differences between the operated and non-operated leg. These differences are not always visible during routine clinical testing but may influence performance and potentially increase the risk of reinjury. By analyzing how force is generated during a standardized countermovement jump, this study seeks to identify whether biomechanical alterations persist at this stage of recovery and to improve decision-making related to rehabilitation and return to sport. Study Design: This is an observational comparative study. Participants who have undergone anterior cruciate ligament reconstruction using a hamstring tendon graft will be assessed between five and seven months after surgery. Their results will be compared with those of healthy recreationally active individuals without a history of recent knee injury. No experimental treatment or modification of rehabilitation will be introduced as part of this study. Procedures: Participants will complete a brief standardized warm-up followed by three maximal vertical countermovement jumps performed on a force platform. During the test, participants will keep their hands on their hips and will be instructed to jump as quickly and as high as possible. The force platform measures ground reaction forces from each leg separately, allowing detailed analysis of the lowering phase (when the body bends before jumping) and the push-off phase (when the body propels upward). The entire testing session lasts only a few minutes and reflects movements commonly used in rehabilitation and sports settings. Measurements: The primary measurements include jump height and the mean force produced by each leg during both the eccentric (lowering) and concentric (push-off) phases of the jump. The study will also calculate limb symmetry indices to determine the degree of difference between the operated and non-operated legs. These measurements provide objective information about neuromuscular recovery and functional performance after surgery. Risks: The procedures involve physical activity comparable to exercises already performed during standard rehabilitation. The risks are minimal and similar to those encountered during routine physical training. Participants may stop the test at any time if they experience discomfort. Potential Benefits: Participants may not receive direct personal benefit from taking part in the study. However, the results may contribute to improving rehabilitation strategies, refining criteria used for return-to-sport decisions, and enhancing long-term functional outcomes after anterior cruciate ligament reconstruction. A better understanding of persistent biomechanical alterations may ultimately help reduce the risk of secondary injury and optimize recovery pathways.
NCT07328139
The main purpose of this study is to evaluate and compare the effects of an 8-week core stabilization exercise program on balance, trunk muscle endurance, and lower body strength. The study includes two groups of participants: 15 individuals who have had Anterior Cruciate Ligament (ACL) reconstruction surgery and 15 healthy individuals. Both groups will perform the same core stabilization exercises for 8 weeks, twice a week, under the supervision of a physiotherapist. The goal is to determine if this exercise program improves balance and core strength in people who have had ACL surgery and to compare these results with those of healthy individuals performing the same exercises.
NCT05342415
In recent years, it has been shown that different focuses (externally vs. internally focused) used when explaining exercises to patients after knee surgeries affect exercise performance and rehabilitation outcomes. Quadriceps muscle inhibition after anterior cruciate ligament reconstruction is one of the primary symptoms that should be treated. This study aimed to investigate the effects of different focusing techniques during the rehabilitation exercises after anterior cruciate ligament rehabilitation.
NCT06845150
The goal of this clinical trial is to investigate changes in cognitive and physical performance after 10 weeks of dual or single task training in anterior cruciate ligament (ACL) reconstructed individuals. The main questions it aims to answer are: * Does cognitive performance in ACL reconstructed individuals change after multiple training sessions incorporating single versus dual-task? * Does physical performance and intrinsic motivation for training change over the course of 10 weeks when performing single versus dual-task training sessions? * What movement patterns do ACL reconstructed individuals show during a dual-task training in an immersive environment? Researchers will compare a combined dual-task training (combined physical and cognitive training) to a single task training (physical and cognitive training separately) to see if there are changes on cognitive performance depending on the training type. Participants will: * Perform dual-task or single task training twice per week for 10 weeks * Visit the clinic before and after the training period for tests * Visit the movement laboratory once for analysis of movement patterns
NCT06818201
Anterior Cruciate Ligament (ACL) is a prevalent injury, particularly among young and physically active individuals. The efficacy of transcranial direct current stimulation (tDCS) and exercise-based rehabilitation on neuromuscular control in post-ACL reconstruction patients is evaluated, and these techniques are combined.
NCT06590402
The goal of this pilot clinical trial is to compare anterior femoral cutaneous nerve block (AFCN) to adductor canal block ACB) for pediatric patients undergoing either anterior cruciate ligament (ACL) or medial patellofemoral ligament (MPFL). The aims of this trial are: * To measure postoperative functional outcomes in patients who received AFCNB vs. ACB. * To calculate postoperative opioid requirements in pediatric knee surgeries that received AFCNB vs. ACB. * To calculate pain intensity levels at rest and with ambulation in patients who received AFCNB vs. ACB. * To quantify sensory deficits in patients who received AFCNB vs. ACB. * To assess patient-reported outcome measures (e.g., pain expectation scale, pain management satisfaction, PROMIS Pediatric Short Form v1.0 - Physical Activity, PROMIS Scale v1.2 - Global Health) in patients 8-18 years of age who received AFCNB vs. ACB. Subjects undergoing ACL procedures will be compared between those who received the adductor canal block to those who received the anterior femoral cutaneous nerve block. The researchers will also compare individuals who underwent MPFL procedures and received an anterior femoral cutaneous nerve block with those who received the adductor canal block. Participants will: * Be randomized to receive either the AFCNB or ACB in addition to standard of care analgesia. * Maintain a patient diary to document daily pain meds/pain scores * Complete follow up surveys/questionnaires via telephone and during their office visits with surgeons.
NCT07128602
After knee surgery for a torn ACL, many women struggle with weak thigh muscles for years, partly due to reduced brain signals to these muscles. Our research tests a new approach to improve recovery by using low-level brain stimulation to boost these signals. The investigators will study 42 women, aged 18-35, who had ACL surgery. They'll be split into two groups: one receiving real brain stimulation and another getting a placebo, both during thigh-strengthening exercises. Over six sessions, the investigators measure thigh muscle strength, speed, and steadiness, plus two brain signal measures, using special equipment. The investigators will also check if stronger brain signals lead to better muscle performance, especially in women. Our goal is to show that this new method strengthens thigh muscles better than standard rehab, helping women recover better after surgery. If successful, this could improve physical therapy for women recovering from ACL surgery, making daily activities and return to sport easier.
NCT06327555
Purpose: Investigate whether telerehabilitation based on wearable devices is clinically as effective as in-person rehabilitation for ACLR patients. Subjects: 164 patients aged ≥18 years who underwent ACLR. Design: A mixed-block randomization method was used to randomly assign participants to two groups: the telerehabilitation group and the in-person rehabilitation group, with a 50% probability of assignment to each group. All participants received standard postoperative rehabilitation training with identical content. The telerehabilitation group received postoperative telerehabilitation guidance via software and sensors. The in-person rehabilitation group received therapist-administered treatment with three rehabilitation sessions per week. All participants underwent regular follow-ups (1 day preoperatively, 3 months postoperatively, and 6 months postoperatively). Primary outcome measure: The primary outcome measure was the Lysholm score. Secondary outcome measures included the IKDC score, Tegner Activity Scale, SF-36 questionnaire, VAS score, and isokinetic muscle strength of the knee joint.
NCT07032623
This single-blind, randomized controlled trial aims to investigate the effects of spinal manipulation on neuromuscular control in individuals with anterior cruciate ligament reconstruction during a single-leg vertical drop landing task. The intervention group will receive spinal manipulation, while the control group will not receive any therapeutic intervention. The main question it aims to answer is: • Can spinal manipulation induce changes in muscle activation, co-contraction magnitude, and biomechanical parameters during landing?
NCT06185803
Observational, ambispective, longitudinal, monocentric, open cohort study of a population of adult patients operated on for ACL reconstruction and receiving postoperative follow-up.
NCT05152758
Anterior cruciate ligament (ACL) ruptures are very common knee injuries amongst youth involved in sports and are often treated through ACL reconstruction surgeries. Unfortunately, up to 50% of individuals who undergo ACL reconstruction develop post-traumatic osteoarthritis (PTOA) in their injured knee by 20 years post-reconstruction causing pain, decreasing mobility, and impacting quality of life in young active individuals. Much remains unknown regarding the secondary prevention of PTOA, and more investigation is necessary to better understand its disease progression post-ACL reconstruction and types of conservative interventions that can prevent or delay its onset. Physical activity has improved patient-reported outcomes across many different chronic diseases including knee osteoarthritis (OA), and physical activity prescription has been shown to be an effective way to increase patients' levels of physical activity. It has not yet been heavily investigated in the context of post-ACL reconstruction, and individuals often exhibit decreased physical activity after ACL reconstruction which causes suboptimal cartilage health. Thus, physical activity prescription may improve habitual joint loading, leading to improved cartilage health and patient-reported health outcomes.
NCT02772770
Pediatric ACL: Understanding Treatment Outcomes (PLUTO) is a multi-center, prospective cohort study. Specific aims of PLUTO are to evaluate the safety and comparative effectiveness of non-operative treatment, as well as four operative treatments including (1) transphyseal ACL reconstruction (2) partial transphyseal ACL reconstruction, (3) physeal-sparing epiphyseal ACL reconstruction using the Anderson technique, and (4) physeal-sparing ACL reconstruction using the Micheli/Kocher technique in prepubescent and pubescent skeletally immature patients.
NCT03184922
Study Aims and Objectives: To investigate the following null hypothesis: that there is no difference in clinical and functional outcome when comparing outcomes of Anterior Cruciate Ligament (ACL) reconstruction when comparing femoral side graft fixation with either a fixed versus an adjustable suspensory loop system. The research team will achieve this aim by: * Enrolling 150 patients into this study over a period of 2 years and 8 months * Carrying out a prospective randomised study looking at the subject matter over a period of 5 years and 8 months * Analysing patients functional status pre and post-surgery using patient generated questionnaires * Quantitatively measuring knee joint laxity using the KT1000 testing device at the 3, 6 and 12 month post-surgery time frames * Collating the data received into a spread sheet for analysis by a professional statistician. It is not uncommon to tear the anterior cruciate ligament (ACL) particularly during sporting activities. Younger and sportier patients will often have this ligament reconstructed so as to allow them to return to sport with a stable knee joint that they feel they can trust. Various surgical techniques exist to perform ACL reconstruction. In Exeter, the favoured technique is to reconstruct the ligament by taking two of the hamstring tendons from the back of the knee and creating a graft with these, passing them through a bony tunnel to replace the torn ACL. On the shin bone side of the knee the graft is fixed in place using a screw. On the thigh bone side, the graft is attached to a device known as a suspensory loop. The length of the graft and the length of the tunnel in the thigh bone vary from patient to patient. It is important to get a good length of the graft material in both the shin and thigh bones so as to give the best chance of the graft attaching to the surrounding bone. With the fixed loop system, once the metal button attached to the outer thigh bone is in place, the length of the loop cannot be adjusted. Thus the amount of hamstring graft in either end of the bony tunnel cannot be changed. One potential advantage of an adjustable loop system is that the amount of graft in either end of the bone tunnel can be altered to ensure sufficient graft is accurately placed. The research team are planning to run this study to identify which type of loop system gives the best outcome for patients, examining the results in different ways including questionnaires to measure how well the patients feel their knee is performing, and specific tests to measure knee function. If patients consent to be in the study, they will be randomly allocated to receive one of the 2 ACL reconstruction options above and their progress monitored for 2 years after the operation. All aspects of surgical care will be as routine practice apart from the decision to fix the graft to the thigh bone with an adjustable or fixed suspensory loop.
NCT06809920
The objetive is compare knee joint stability, functional capacity, postural control, activation, and muscle strength of patients undergoing conventional Anterior Cruciate Ligament Reconstruction or the conventional Anterior Cruciate Ligament Reconstruction + Anterolateral Ligament Reconstruction technique of the knee, and rehabilitation for up to nine months. This project aims to include patients with ACL injuries already treated at the Knee Outpatient Clinic of the Hospital das Clínicas da UEL (HC-UEL), coordinated by the orthopedic physician Dr. Lucas da Fonseca Borghi, who has his master's degree related to this research project. Twenty patients between 18 and 50 years old, of both sexes, sedentary and/or active and/or athletes, diagnosed with unilateral injury of the Anterior Cruciate Ligament will be included. These patients will be evaluated, submitted to ACL surgery (conservative) or associated with ALL reconstruction and undergo rehabilitation with physiotherapy in conjunction with the extension project Sports Physiotherapy from Theory to Practice - Phase III (PROEX-UEL No 02675), coordinated by Prof. Dr. Christiane S. Guerino Macedo - advisor of this research. Expected results: It is expected that the group undergoing ACL + ALL reconstruction will present better knee joint stability, functional capacity, postural control, activation and muscle strength.
NCT05972876
Rationale Graft maturity is correlated with strength and biomechanical properties of the reconstructed ACL. There are concerns that heavy-load resistance training (HLRT) may have detrimental effects on ACL graft maturation. Therefore, low-load blood flow restriction training (LL-BFRT) has been suggested as an alternative to HLRT. As LL-BFRT is an increasingly popular method for the rehabilitation after an ACL reconstruction, it is important to evaluate the value of this treatment. Objectives The main objective is to evaluate the effect of LL-BFRT on MRI-based graft maturity after ACL reconstruction compared to HLRT. The secondary objectives are the effect of LL-BFRT on donor-site morbidity, range of motion, knee stability, patient reported outcome measurements, muscle strength, safe return to pre-injury level of sport and patient satisfaction. Furthermore, feasibility and safety of rehabilitation will be assessed. Study design Randomized controlled trial . Study population Patients who will undergo primary bone-patellar tendon-bone ACL reconstruction and rehabilitation at Knie-Heup centrum Plus will be assessed for eligibility. The exclusion criteria are: venous thromboembolism, sickle cell anemia, severe hypertension, contra-indication for accelerated rehabilitation, contra-indication for MRI scan or patients who are not willing/able to participate. Intervention LL-BFRT includes 12 weeks of biweekly strength training and starts two weeks after surgery. Comparison HLRT includes 12 weeks of biweekly strength training and starts two weeks after surgery. Main study endpoints The main endpoints are MRI-based graft maturity defined as signal-to-noise quotient three and nine months after surgery.
NCT06318039
Scientific Research Question Overall Purpose: Regarding rehabilitation after anterior cruciate ligament reconstruction (ACLR), there is a knowledge gap - a lack of evidence. Important questions such as how rehabilitation should be structured, what it should include, and how it should be evaluated are currently not clear. Therefore, the investigators plan to conduct a two-year follow-up randomized controlled trial (RCT) on post-ACLR rehabilitation. Moreover, detailed information on how/under what circumstances the ACL injury occurred is not satisfactorily described in the literature. Therefore, the investigators are planning a new survey that can identify, explain, and prevent the risk factors causing a person to suffer from an anterior cruciate ligament injury. Specific Objectives: How should guidelines for rehabilitation after ACLR be structured, what should they include, and how should they be evaluated to best restore knee function in the patient? Can a detailed and comprehensive survey identify, explain, and prevent the risk factors causing a person to suffer from an ACL injury?
NCT06280456
Post-anterior cruciate ligament reconstruction (ACLR) hemarthrosis may result in increased pain thus delaying postoperative rehabilitation, which may eventually lead to arthrofibrosis and a functional deficit. Many antifibrinolytic agents, including tranexamic acid (TXA), have been used in orthopedic surgeries to reduce postoperative bleeding. Moreover, TXA was proved effective to reduced the events of hemarthrosis and increased the post-operative functional outcomes of the patients in several studies. The purpose of this study is to evaluate the efficacy of intra-articular injection of TXA with different drainage clamping time in patients receiving arthroscopic ACLRs. Patients were randomized into four groups. An intra-articular suction drain was placed recorded 24 h postoperatively. Group 1 patients(TXA 4hr group) received the index procedures with a 10 mL intra-articular injection of TXA and following drainage clamped 4 hours. Group 2 patients(TXA 8hr group) received the index procedures with a 10 mL intra-articular injection of TXA and following drainage clamped 8 hours. Clinical evaluations using an IKDC functional score and a Visual Analogue Scale (VAS) pain score were performed during admission, at postoperative day 3 and week 4.