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Tania Pizzari, Helen McBurney, Nicholas F. Taylor and Julian A. Feller


To investigate the subjective experience of anterior cruciate ligament (ACL) rehabilitation and identify variables that influence adherence as perceived by ACL-reconstructed patients.


A qualitative study using in-depth interviews to gather data and thematic coding to analyze findings.


Participants were interviewed at home or in their workplace.


Eleven patients were interviewed at an average of 4.8 months (SD = 0.8) after ACL reconstruction.


Using thematic coding of the interview data, 3 categories of variables influencing adherence emerged: environmental factors, physical factors, and psychological factors. Variables specifically affecting adherence to home exercise were perceived lack of time and a lack of self-motivation. Fear of reinjury emerged as a significant consideration for those who were nonadherent. Factors such as therapist support, the rehabilitation clinic, and the progression of exercises were identified as being important for attendance at physiotherapy appointments and adherence during appointments.

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Liam Anderson, Graeme L. Close, Matt Konopinski, David Rydings, Jordan Milsom, Catherine Hambly, John Roger Speakman, Barry Drust and James P. Morton

Anterior cruciate ligament (ACL) injury is a troublesome and potentially serious injury in soccer that often requires surgical reconstruction ( Brophy et al., 2012 ). After ACL reconstruction, an athlete’s return-to-play time is reported to range from 16 to 52 weeks ( Zaffagnini et al., 2014

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Selvin Balki and Hanım Eda Göktas¸

Nowadays, the number of anterior cruciate ligament (ACL) injuries has increased as a result of a positive attitude developing toward exercise and sports. 1 Annual incidence rate of an ACL injury is 3.5% among amateur athletes. 1 The incidence rate of an ACL injury in females is higher than males

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Sungwan Kim, Daeho Kim and Jihong Park

Knee pathologies are a common musculoskeletal problem. For example, approximately 25% of the athletic or general population experience anterior knee pain (AKP), 1 the incidence of anterior cruciate ligament (ACL) tears is 68.6 per 100,000 person-years, 2 and meniscal tears affect an estimated 35

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Takuma Hoshiba, Hiroki Nakata, Yasuaki Saho, Kazuyuki Kanosue and Toru Fukubayashi

Anterior cruciate ligament (ACL) injury and/or reconstruction may alter knee proprioception. 1 – 3 Previous studies have provided evidence of the presence of mechanoreceptors within the ACL, including Ruffini and Pacinian corpuscles, Golgi tendon organs, and free nerve endings, and of the

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Kelly R. Holcomb, Cheryl A. Skaggs, Teddy W. Worrell, Mark DeCarlo and K. Donald Shelbourne

A paucity of information exists concerning reliability of the KT-1000 knee arthrometer (MEDmetric Corp., San Diego, CA) when used by different clinicians to assess the same anterior cruciate ligament-deficient patient. The purpose of this study was to determine the reliability and standard error of measurement of four clinicians who routinely report KT-1000 arthrometer values to referring orthopedic surgeons. Two physical therapists and two athletic trainers performed anterior laxity tests using the KT-1000 on 19 subjects. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were used to determine reliability. Intratester ICC ranged from .98 to 1.0 and intratester SEM ranged from 0.0 to .28 mm. Intertester ICC and SEM for all four testers were .53 and 1.2 mm, respectively. A 95% confidence interval (M ± 1.96 × SEM) of the intertester variability ranged from −0.18 to 4.52 mm. Therefore, large intertester variation existed in KT-1000 values. Each facility should standardize testing procedures and establish intratester and intertester reliability for all clinicians reporting KT-1000 values.

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Yoshiko Hasebe, Yoshie Tanabe and Kazunori Yasuda


Anterior cruciate ligament (ACL) reconstruction with doubled hamstring autograft might not sufficiently improve fundamental sports abilities of patients with ACL-deficient knees.


To clarify whether ACL reconstruction using the hamstring graft can improve fundamental sports abilities.


Patients were examined twice, preoperatively and 2 years postoperatively, using the conventional evaluation scales and performance tests.


15 athletic patients with ACL reconstruction using hamstring autograft.


A stairs-run test and figure-8 one-leg hop test. Muscle strength and knee stability were measured with Cybex® II and KT-2000® arthrometers, respectively.


There were no significant differences between the preoperative and postoperative results in the performance tests. The degree of postoperative recovery in the subjective score, the anterior translation of the tibia, and the isokinetic muscle strength was not significantly correlated with the degree of restoration in each performance test.


Postoperative restoration as measured by conventional evaluation scales is not correlated with restoration of sports abilities in patients with ACL insufficiency.

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Arika L. Cozzi, Kristina L. Dunn, Josie L. Harding, Tamara C. Valovich McLeod and Cailee E. Welch Bacon

Clinical Scenario:

There are approximately 200,000 anterior cruciate ligament (ACL) tears reported annually in the United States. Patients who undergo ACL reconstruction followed by an aggressive rehabilitation protocol can often structurally and functionally progress to a preinjury level. Despite physical improvements with ACL-rehabilitation protocols, however, there are still a substantial number of individuals who do not return to preinjury level, particularly physically active individuals, of whom only 63% return to their full potential preinjury level. This may be due to continued pain, swelling, stiffness, and weakness in the knee. In addition, research concerning the topic of kinesiophobia (ie, fear of reinjury), which may prevent individuals from returning to their activities, has increased over the past several years. Kinesiophobia is defined as the irrational or debilitating movement of physical activity resulting in the feeling of vulnerability to painful injury or reinjury. Kinesiophobia may have a significant impact on physically active individuals, considering the proportion of patients who do not return to their sport. However, it is unknown whether kinesiophobia is associated with patients’ perceived physical-impairment levels after ACL reconstruction.

Focused Clinical Question:

Is kinesiophobia associated with self-perceived levels of knee function after ACL reconstruction?

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Justin L. Rush, Lindsey K. Lepley, Steven Davi and Adam S. Lepley

Approximately 80,000 to 250,000 anterior cruciate ligament (ACL) injuries occur annually in the United States. 1 Unfortunately, a portion of these patients can experience poor long-term outcomes following ACL reconstruction (ACLR) which is evident by reinjury rates that exceed 20%, 2 and

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Aaron Derouin and Jim R. Potvin

Injuries to the knee account for up to 60% of all sports injuries. 1 Almost half of all reported knee injuries involve disruption to the anterior cruciate ligament (ACL). 1 , 2 Functional knee braces are designed to provide support to unstable knees by reducing anterior tibial translation and