Importance of ACL state follow-up: A new vision of ACL rehabilitation
Whether you're a professional sports player or a simple sports addict, I believe that there is nothing worse than hearing your doctor say "It seems that you have torn your ACL*" during a clinical examination.
Why is that? Well, for those of you who don't know it, recovering from such an injury takes time. And I am not talking about a few weeks of rehab... Usually, the average time of rehab needed takes up to 6 months. Can you imagine how that feels for a person who usually plays sports everyday? Not good, I can guarantee you that but mental health isn't going to be the main topic of this article but rather how to optimize rehab after ACL surgery.
As mentioned above, it usually takes up to 6 months to start practicing sports again after an ACL Surgery and it was thought that the surgical technique employed was the only key contributor for obtaining knee stability. This way of thinking is slowly changing because of two factors: outpatient surgery (or ambulatory surgery) and medical devices.
Outpatient surgery is definitely playing a great role in proving that rehab is very important as it lets patients all over the world have surgery and come home the same day. Consequently, some of them didn't even think rehab would be needed and most of the time, some years later, they were seen undergoing another surgery because the first one was inefficient. The reason this happened is often the same: Movements that put the ACL graft in too much stress were probably done during their rehab and this slowly but surely, led to the graft breaking again.
On the other hand, technology also defines the importance of rehab as some devices like the GNRB Classic allow the ACL to be analyzed with precision. Using this device during the rehabilitation phase can indeed be very useful as it allows orthopaedic surgeons, sports doctors and physiotherapists in getting feedback on the state and performance of the ACL at any given time. The results given can guide the medical practitioners in choosing the correct rehabilitation program at the right time and it also allows them to monitor to ensure no harmful movements are done to the ACL graft while at home (because of the outpatient surgery).
GNRB Classic: Automated tibial translation device
ACL follow-up has also proven to be very useful through the usage of this device as it particularly helped in the field of communication between the patient and the medical practitioners. The reason why that is is that the results are shown in the form of graphs that are easy to comprehend (Its not like when a patient sees an X-ray image). Therefore, the patient can quickly be notified whether their new ACL is in a good state or if they should be more careful with their every day movements.
Here is an example of two twin sisters who both suffered isolated ACL tears. What is interesting in this case is that they underwent surgery with same surgeon and the same surgical technique but one year later different results were observed. The curves above represent the stiffness of each ACL of both of their knees one year after the surgery. One of them had stable knees (Patient 2) whereas the other had an unstable knee (Patient 1, blue curve). This was explained because one sister underwent strict rehab whereas the other one was more aggressive towards her ACL graft.
This is a good example of why ACL state follow-up is important as it points out the fact that if the patient who wasn't careful with her rehab had underwent GNRB Classic tests soon enough, she would have avoided putting her ACL graft under too much stress and consequently would have let the healing take place normally to eventually lead to a stable knee (it should be also noted that she did not feel that she was applying too much stress).
If you have are interested in knowing more about the GNRB Classic, check out this website:
You can also contact me on [email protected] or leave me a comment.
-Yves Crystal
*Anterior Cruciate Ligament