Efficacy of Preoperative Re-education on Patients With an Anterior Cruciate Ligament Rupture
- Conditions
- Anterior Cruciate Ligament Rupture
- Interventions
- Behavioral: Preoperative re-education
- Registration Number
- NCT02505659
- Lead Sponsor
- University Hospital, Clermont-Ferrand
- Brief Summary
Anterior cruciate ligament (ACR) rupture is a common lesion of sportsmen that leads to functional deficits which are difficult to overcome. To prevent from an unfavorable evolution, patients can either get a non-surgical treatment or an ACR surgery, which is very common. Knee functional performance level could impact on the postoperative outcome and it's of common knowledge that early re-education after an ACR rupture improves knee functioning.
Patients with an ACR rupture enrolled in this study will be randomized either in an experimental group (with preoperative reeducation) or in a control group (without preoperative reeducation). Both groups will then have post-operative re-education (40 sessions) based on HAS recommendations.
The main aim of this study is to assess the impact of preoperative re-education on knee functional performance 4 month after surgical reconstruction of an ACR.
Secondary aims are to determine the impact of the 4-week preoperative re-education on knee functional performance after an ACR rupture, before surgery and 7 months after surgery.
Functional performance, muscular strength, proprioception and anterior knee laxity will be measured at inclusion (V0), 4-5 days before surgery (V1), 4 month (V4M) and 7 months (V7M) after surgery. Lysholme-Tegner scoring and IKDC2000 questionnaire will be added to the previous assessments.
- Detailed Description
Anterior cruciate ligament (ACR) rupture is a common lesion of sportsmen that leads to functional deficits which are difficult to overcome. To prevent from an unfavorable evolution, patients can either get a non-surgical treatment or an ACR surgery, which is very common. Knee functional performance level could impact on the postoperative outcome and it's of common knowledge that early re-education after an ACR rupture improves knee functioning.
Patients with an ACR rupture enrolled in this study will be randomized either in an experimental group (with preoperative reeducation) or in a control group (without preoperative reeducation). Both groups will then have post-operative re-education (40 sessions) based on HAS recommendations.
The main aim of this study is to assess the impact of preoperative re-education on knee functional performance 4 month after surgical reconstruction of an ACR.
Secondary aims are to determine the impact of the 4-week preoperative re-education on knee functional performance after an ACR rupture, before surgery and 7 months after surgery.
Functional performance, muscular strength, proprioception and anterior knee laxity will be measured at inclusion (V0), 4-5 days before surgery (V1), 4 month (V4M) and 7 months (V7M) after surgery. Lysholme-Tegner scoring and IKDC2000 questionnaire will be added to the previous assessments.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 80
- Patients between 18 and 45 years old
- Tegner physical activity level between 3 and 9
- Primary and unilateral rupture of anterior cruciate ligament, confirmed by MRI
- patient available to carry out the preoperative re-education program
- Complex lesion that would impede on preoperative re-education (posterior cruciate ligament, meniscal or chondral symptomatic lesion, fracture)/
- Neurologic or cardiorespiratory pathology contra-indicating preoperative re-education
- Previous surgical treatment of the lower limbs or of the lumbar spine
- Neuropathic or algodystrophic pain on the lower limbs
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description EXPERIMENTAL GROUP Preoperative re-education Sessions are aiming to neuromuscular and functional training. Each session starts with trunk muscle activation. Patients will then have to realize a neuromuscular training on Huber Motion Lab® followed by multiple exercises targeting functional stability and neuromuscular control. From the 4th session, a jump sequence will be added to the previous exercices. Exercises used in this protocol are based upon successful exercises of protocols already performed on patients with anterior cruciate ligament rupture.
- Primary Outcome Measures
Name Time Method Functional performance as assessed by single-leg hop for distance test performance at 4 months after ACR surgery.
- Secondary Outcome Measures
Name Time Method Subjective knee evaluation as assessed by International Knee Documentation committee 2000 questionnaire at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Quadriceps muscular strength as assessed by isokinetic test of quadriceps muscular strength at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Proprioception as assessed by repositioning knee test at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Ability to return to high level athletics as assessed by single-leg hop for distance test performance at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Dynamic balance as assessed by star excursion balance test at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Physical activity level as assessed by Tegner knee scoring at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Knee anterior stability as assessed by KT-1000 at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Knee symptoms as assessed by Lysholme questionnaire at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M)
Trial Locations
- Locations (1)
CHU Clermont-Ferrand
🇫🇷Clermont-Ferrand, France