Three physical therapists shared Shelbourne Knee Center research results at the American Physical Therapy Association Combined Sections Meeting in January. Three of the presentations focused on identifying best practices for rehab after anterior cruciate ligament (ACL) reconstruction. The fourth presentation was a patellar tendon rupture case study.
“We don’t keep what we do secret. We want everyone to have education and be empowered to help their patients get the best knee care,” says Sarah Eaton, PT, DPT, ATC, LAT, a physical therapist/athletic trainer at Shelbourne Knee Center. Eaton, Bill Claussen, MPT, and Scot Bauman, PT, DPT, shared results from long-term follow-up of patients at Shelbourne Knee Center during four presentations.
Practical Results for the Field
Unlike much of the research presented at the APTA Combined Sections Meeting, Shelbourne Knee Center’s rehab and physical therapy protocols don’t require expensive or high-tech equipment and facilities. “We do things simply,” says Sarah. “General PTs can easily reproduce our protocols.”
Three of the presentations focused on rehab after anterior cruciate ligament (ACL) reconstruction. The fourth presentation was a patellar tendon rupture case study.
Return to Competitive Sport
Presenters: Claussen, Eaton, and Bauman
Subjects and Methods:
- 120 school-age Level 9 athletes who underwent ACL reconstruction using a contralateral patellar tendon graft (PTG) from 2009–2013
- 80% of the athletes returned to the same level of sport or higher
- The Shelbourne Knee Center return to sport rate was nearly double that found by a systematic review and meta-analysis published in the British Journal of Sports Medicine2
- Female athletes had a higher rate of return to sport than male athletes:
- Females: 83%
- Males: 75%
Read more about this study.
Quadriceps Muscle Strength
Presenters: Claussen, Bauman and Eaton
Subjects and Methods: 217 patients who underwent primary ACL reconstruction using a contralateral PTG from 2009–2013
- 98% of patients achieved full extension in the ACL knee at 1 month post-op
- 94% of patients achieved normal extension and flexion in the ACL knee compared to the opposite knee at 1 year post-op
Quadriceps strength in both legs also returned:
- ACL knee:
- 91% at 6 months post-op
- 101% at 1 year post-op
- Donor knee:
- 84% at 6 months post-op
- 95% at 1 year post-op
Read more about this study.
Range of Motion and Quadriceps Strength
Title: Effect of knee range of motion on return to full quadriceps strength at 1 year post-op following anterior cruciate ligament reconstruction with contralateral patellar tendon graft
Subjects and Methods: 978 patients who underwent primary ACL reconstruction using a contralateral PTG from 1988–2012
- 891 patients had normal range of motion (ROM) and 87 patients had abnormal ROM at 1 year post-op
- Symmetrical strength within 10% between the knees:
- 60% of patients with normal ROM
- 47.2% of patients with abnormal ROM
- Mean quadriceps strength at 60°/seconds:
- 105.6% in the normal ROM group
- 101.4% in the abnormal ROM group
- Mean quadriceps strength at 180°/seconds:
- 100.9% in the normal ROM group
- 97.3% in the abnormal ROM group
Patellar Tendon Repair
Title: Rehabilitation and outcomes following a patellar tendon repair using a Dall-Miles cable: A retrospective case study
Subjects and Methods: A 35-year-old recreational athlete ruptured his right patellar tendon while playing basketball. Treatment involved:
- Pre-op rehab to maximize ROM and decrease swelling
- Patellar tendon repair with a Dall-Miles cable followed by bed rest for one week while wearing an immobilizer when walking
- Rehab to achieve full extension, maximize flexion as allowed by the cable, reduce swelling, and achieve normal leg control and gait
- Another surgery to remove the cable (3 months post-op) followed by bed rest
- Rehab to attain symmetric ROM and strength
- After cable removal surgery, the patient attained symmetric extension at day 3 post-op, symmetric flexion and no joint effusion at 4 weeks, and nearly normal quadriceps strength at 8 weeks.
- The patient attained symmetric quadriceps strength at 4 months and maintained this at 8 months.
Shelbourne Knee Center physical therapists also will be presenting their research at Community Health Network’s 4th Annual Multidisciplinary Symposium at the University of Indianapolis on May 8, 2019.
Eaton, Claussen and Bauman will be giving their APTA presentations again. Other presentations are:
- Full knee range of motion: The key to knee rehabilitation, by Laura Bray-Prescott, PT/LATC and Darla Baker, PT, DPT, ATC/L
- The effect of body mass index on functional outcomes following total knee arthroplasty, by Rachel Krupski, PT, DPT
The symposium highlights the partnership between the university and Community Health Network. Shelbourne Knee Center is part of Community Health Network, an integrated healthcare system in Central Indiana.
For more information about physical therapy, call 888-FIX-KNEE.
- Bauman S, Claussen W. Return to competitive sports after ACL reconstruction. Poster session, 2018 Indiana American Physical Therapy Association and Kentucky American Physical Therapy Association Joint Conference, September 2018, Louisville, Ky and American Physical Therapy Association Combined Sections Meeting, January 2019, Washington, DC.
- Arden CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45(7):596-606.)
- Claussen W, Bauman S. Return of bilateral quadriceps muscle strength following anterior cruciate ligament reconstruction using a contralateral patellar tendon graft, presentation at 2018 Indiana American Physical Therapy Association and Kentucky American Physical Therapy Association Joint Conference, September 2018 and American Physical Therapy Association Combined Sections Meeting, January 2019, Washington, DC.
- Eaton S. Effect of Knee Range of Motion on Return to Full Quadriceps strength at 1 year Post-op Following Anterior Cruciate Ligament Reconstruction with Contralateral Patellar Tendon Graft. Presented at American Physical Therapy Association Combined Sections Meeting, January 2019.
- Bauman S. Rehabilitation and outcomes following a patellar tendon repair using a Dall-Miles cable: a retrospective study. Presented at American Physical Therapy Association Combined Sections Meeting, January 2019.