Abstract
STUDY DESIGN: Systematic literature review. TTOBJECTIVE: To systematically review the literature relative to muscle performance, knee joint biomechanics, and performance-based functional outcomes following articular cartilage repair and restoration surgical procedures in the knee. TTBACKGROUND: Articular cartilage injuries are associated with functional limitations, poor quality of life, and the potential for long-term disability. This review systematically evaluates evidence related to muscle performance, joint biomechanics, and performance-based functional outcomes following articular cartilage procedures, and discusses their implications for rehabilitation. TTMETHODS: The online databases of PubMed (MEDLINE), CINAHL, SPORTDiscus, and Scopus were searched (inception to September 2013). Studies pertaining to muscle performance, knee joint biomechanics, and performance-based measures of function following articular cartilage procedure in the knee were included. TTRESULTS: Sixteen articles met the specified inclusion criteria. Seven studies evaluated muscle performance, all showing persistent deficits in quadriceps femoris muscle strength for up to 7 years postprocedure. Quadriceps femoris strength deficits of greater than 20% were noted in 33% and 26% of individuals at 1 and 2 years following microfracture and autologous chondrocyte implantation (ACI), respectively. Two studies evaluated knee mechanics post-ACI, showing persistent deficits in knee kinematics and kinetics for up to 12 months postprocedure compared to uninjured individuals. Seven studies showed improved functional capacity (6-minute walk test) over time, and 3 studies showed persistent performance deficits during higher-level activities (single-leg hop test) for up to 6 years postprocedure. Five studies comparing weight-bearing protocols (accelerated versus traditional/current practice) following ACI found few differences between the groups in function and gait mechanics; however, persistent gait alterations were observed in both groups compared to uninjured individuals. TTCONCLUSION: Significant quadriceps femoris strength deficits, gait deviations, and functional deficits persist for 5 to 7 years following ACI and microfracture surgical procedures. Future research regarding rehabilitation interventions to help mitigate these deficits is warranted.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 565-578 |
| Number of pages | 14 |
| Journal | Journal of Orthopaedic and Sports Physical Therapy |
| Volume | 44 |
| Issue number | 8 |
| DOIs | |
| State | Published - Jan 1 2014 |
| Externally published | Yes |
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Keywords
- Gait
- Microfracture
- Strength
- Sutologous chondrocyte implantation
ASJC Scopus subject areas
- Physical Therapy, Sports Therapy and Rehabilitation
- Medicine(all)
Cite this
Functional outcomes after surgical management of articular cartilage lesions in the knee : A systematic literature review to guide postoperative rehabilitation. / Schmitt, Laura C.; Quatman, Carmen E.; Paterno, Mark V.; Best, Thomas; Flanigan, David C.
In: Journal of Orthopaedic and Sports Physical Therapy, Vol. 44, No. 8, 01.01.2014, p. 565-578.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Functional outcomes after surgical management of articular cartilage lesions in the knee
T2 - A systematic literature review to guide postoperative rehabilitation
AU - Schmitt, Laura C.
AU - Quatman, Carmen E.
AU - Paterno, Mark V.
AU - Best, Thomas
AU - Flanigan, David C.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - STUDY DESIGN: Systematic literature review. TTOBJECTIVE: To systematically review the literature relative to muscle performance, knee joint biomechanics, and performance-based functional outcomes following articular cartilage repair and restoration surgical procedures in the knee. TTBACKGROUND: Articular cartilage injuries are associated with functional limitations, poor quality of life, and the potential for long-term disability. This review systematically evaluates evidence related to muscle performance, joint biomechanics, and performance-based functional outcomes following articular cartilage procedures, and discusses their implications for rehabilitation. TTMETHODS: The online databases of PubMed (MEDLINE), CINAHL, SPORTDiscus, and Scopus were searched (inception to September 2013). Studies pertaining to muscle performance, knee joint biomechanics, and performance-based measures of function following articular cartilage procedure in the knee were included. TTRESULTS: Sixteen articles met the specified inclusion criteria. Seven studies evaluated muscle performance, all showing persistent deficits in quadriceps femoris muscle strength for up to 7 years postprocedure. Quadriceps femoris strength deficits of greater than 20% were noted in 33% and 26% of individuals at 1 and 2 years following microfracture and autologous chondrocyte implantation (ACI), respectively. Two studies evaluated knee mechanics post-ACI, showing persistent deficits in knee kinematics and kinetics for up to 12 months postprocedure compared to uninjured individuals. Seven studies showed improved functional capacity (6-minute walk test) over time, and 3 studies showed persistent performance deficits during higher-level activities (single-leg hop test) for up to 6 years postprocedure. Five studies comparing weight-bearing protocols (accelerated versus traditional/current practice) following ACI found few differences between the groups in function and gait mechanics; however, persistent gait alterations were observed in both groups compared to uninjured individuals. TTCONCLUSION: Significant quadriceps femoris strength deficits, gait deviations, and functional deficits persist for 5 to 7 years following ACI and microfracture surgical procedures. Future research regarding rehabilitation interventions to help mitigate these deficits is warranted.
AB - STUDY DESIGN: Systematic literature review. TTOBJECTIVE: To systematically review the literature relative to muscle performance, knee joint biomechanics, and performance-based functional outcomes following articular cartilage repair and restoration surgical procedures in the knee. TTBACKGROUND: Articular cartilage injuries are associated with functional limitations, poor quality of life, and the potential for long-term disability. This review systematically evaluates evidence related to muscle performance, joint biomechanics, and performance-based functional outcomes following articular cartilage procedures, and discusses their implications for rehabilitation. TTMETHODS: The online databases of PubMed (MEDLINE), CINAHL, SPORTDiscus, and Scopus were searched (inception to September 2013). Studies pertaining to muscle performance, knee joint biomechanics, and performance-based measures of function following articular cartilage procedure in the knee were included. TTRESULTS: Sixteen articles met the specified inclusion criteria. Seven studies evaluated muscle performance, all showing persistent deficits in quadriceps femoris muscle strength for up to 7 years postprocedure. Quadriceps femoris strength deficits of greater than 20% were noted in 33% and 26% of individuals at 1 and 2 years following microfracture and autologous chondrocyte implantation (ACI), respectively. Two studies evaluated knee mechanics post-ACI, showing persistent deficits in knee kinematics and kinetics for up to 12 months postprocedure compared to uninjured individuals. Seven studies showed improved functional capacity (6-minute walk test) over time, and 3 studies showed persistent performance deficits during higher-level activities (single-leg hop test) for up to 6 years postprocedure. Five studies comparing weight-bearing protocols (accelerated versus traditional/current practice) following ACI found few differences between the groups in function and gait mechanics; however, persistent gait alterations were observed in both groups compared to uninjured individuals. TTCONCLUSION: Significant quadriceps femoris strength deficits, gait deviations, and functional deficits persist for 5 to 7 years following ACI and microfracture surgical procedures. Future research regarding rehabilitation interventions to help mitigate these deficits is warranted.
KW - Gait
KW - Microfracture
KW - Strength
KW - Sutologous chondrocyte implantation
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UR - http://www.scopus.com/inward/citedby.url?scp=84905757223&partnerID=8YFLogxK
U2 - 10.2519/jospt.2014.4844
DO - 10.2519/jospt.2014.4844
M3 - Review article
C2 - 24955815
AN - SCOPUS:84905757223
VL - 44
SP - 565
EP - 578
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
SN - 0190-6011
IS - 8
ER -