Evidence map›Paper›PMID 34903114›Full record

GuidelineSports health

ACL Reconstruction Rehabilitation: Clinical Data, Biologic Healing, and Criterion-Based Milestones to Inform a Return-to-Sport Guideline.

Alexander W Brinlee, Scott B Dickenson, Airelle Hunter-Giordano, Lynn Snyder-Mackler

Registry-linked trialOpen access · greenAbstract readReviewPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Sports health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06096259 (Preventing Injured Knees From osteoArthritis), which is not on this map. Cited by 93 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 8 pooled it
20.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06096259 phase2recruitingnot on this map

Preventing Injured Knees From osteoArthritis: Severity Outcomes (PIKASO)

TypeinterventionalSponsorBrigham and Women's HospitalRan2024 to 2029Enrolled512ConditionsOsteoarthritis, Knee, Post-traumatic Osteoarthritis, ACL TearArmsMetformin, Placebo
3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 8 syntheses or guidelines pooled it, 175 citations in OpenAlex.

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33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Alexander W BrinleeDepartment of Physical Therapy, University of Delaware, Newark, Delaware.
Scott B DickensonDepartment of Physical Therapy, University of Delaware, Newark, Delaware.
Airelle Hunter-GiordanoDepartment of Physical Therapy, University of Delaware, Newark, Delaware.
Lynn Snyder-MacklerDepartment of Physical Therapy, University of Delaware, Newark, Delaware.
University of Delaware · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextAnterior cruciate ligament (ACL) reconstruction (ACLR) and postoperative rehabilitation continues to be a multidisciplinary focus in both research and clinical environments. Recent research on ACLR warrants a reexamination of clinicians' current rehabilitation practices to optimize the strikingly variable clinical outcomes after ACLR and return to sport. The purpose of the article and updated guidelines is to use contemporary evidence to systematically revisit our practice guidelines and validate our clinical milestones with data from our university-based practice. EVIDENCE ACQUISITION: Using the PubMed search engine, articles that reported on ACLR rehabilitation and protocols, guidelines, graft type, healing and strain, return to sport, psychological considerations, and secondary injury prevention published from 1979 to 2020 were identified using the search terms STUDY

designClinical review. LEVEL OF EVIDENCE: Level 5.

resultsClinical milestones after ACLR were validated using clinical data collected from 2013 to 2017 at a university-based practice. Variables including knee joint range of motion, effusion, Knee Outcome Survey-Activities of Daily Living Scale, and quadriceps strength index were tracked throughout rehabilitation and analyzed to help inform an updated ACLR rehabilitation guideline.

conclusionIncorporating the latest research, combined with direct clinical data, provides a current, realistic, and clinically benchmarked strategy for ACLR rehabilitation. Commonly held clinical beliefs regarding rehabilitation after ACL injury must be challenged by the latest research to improve patient outcomes and decrease the risk of reinjury. Key updates to the practice guidelines include the use of frequent and accurate quadriceps strength testing, delayed return-to-sport timeline, immediate use of open kinetic chain exercise, criterion-based progressions for running, sprinting, plyometrics, agility, cutting/pivoting, return to competition, and the inclusion of a secondary prevention program after return to sport. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): B.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionBiological ProductsActivities of Daily LivingHumansReturn to SportBiological ProductsACL reconstructionACLR rehabilitationopen kinetic chain versus closed kinetic chain exercisequadriceps strengthreturn to sport

Identifiers

PMID34903114
PMCPMC9460090
OpenAlexW4200440427

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.