Materiały źródłowe

• #1 Physical prognostic factors predicting outcome following anterior cruciate ligament reconstruction: protocol for a systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7170562/

  Injuries of the anterior cruciate ligament (ACL) are a common musculoskeletal complication and can cause significant reduction in patient function and quality of life. […] Knowledge of physical prognostic factors, such as quadriceps strength, is crucial to inform rehabilitation and has important implications for outcome following ACL reconstruction. […] Physical prognostic factors of interest will reflect a range of domains and may be modifiable/non-modifiable. […] Successful outcome, or research focusing on outcome, is not well defined within the literature, with multiple definitions suggested. […] Following ACL reconstruction or revision, outcome measures recommended for the evaluation of outcome vary and include both patient-reported outcome measures and performance-based outcome measures.

• #2 Physical prognostic factors predicting outcome following anterior cruciate ligament reconstruction: protocol for a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/10/3/e033429

  Injuries of the anterior cruciate ligament (ACL) are a common musculoskeletal complication and can cause significant reduction in patient function and quality of life. […] Knowledge of physical prognostic factors, such as quadriceps strength, is crucial to inform rehabilitation and has important implications for outcome following ACL reconstruction. […] Therefore, the aim of this systematic review is to establish physical prognostic factors predictive of outcome in adults following ACL reconstruction. […] Successful outcome, or research focusing on outcome, is not well defined within the literature, with multiple definitions suggested. […] Following ACL reconstruction or revision, outcome measures recommended for the evaluation of outcome vary and include both patient-reported outcome measures and performance-based outcome measures.

• #3 Physical prognostic factors predicting outcome following anterior cruciate ligament reconstruction: protocol for a systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7170562/

  Several studies have suggested that numerous physical prognostic factors can impact and predict the outcome following ACL reconstruction. […] In the context of this review, we define physical prognostic factors as being physical in nature, including both modifiable factors, for example, quadriceps strength, and non-modifiable factors, for example, age, recognising that both can have a physical effect and influence outcome. […] Few systematic reviews have investigated factors predicting successful outcome after ACL reconstruction, where successful outcome could be quantified using the performance-based outcome measures such as return to sport or return to a previous level of activity, or improvement in the patient-reported outcome measure scores. […] From these reviews, multiple factors have been identified which are associated with poorer outcome, such as being a smoker, preoperative quadriceps strength deficit of 20% or more, preoperative knee range of motion limitations, increased pain, ACL or knee laxity and concomitant meniscal injury.

• #4 Physical prognostic factors predicting outcome following anterior cruciate ligament reconstruction: protocol for a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/10/3/e033429

  As highlighted, it is common that a long-term goal is to allow individuals to return to their prior levels of activity. […] However, events such as an ACL reconstruction can also have a significant impact on the personal life of the individual, with prolonged periods of rehabilitation often required. […] Several studies have suggested that numerous physical prognostic factors can impact and predict the outcome following ACL reconstruction. […] In the context of this review, we define physical prognostic factors as being physical in nature, including both modifiable factors, for example, quadriceps strength, and non-modifiable factors, for example, age, recognising that both can have a physical effect and influence outcome. […] Few systematic reviews have investigated factors predicting successful outcome after ACL reconstruction, where successful outcome could be quantified using the performance-based outcome measures such as return to sport or return to a previous level of activity, or improvement in the patient-reported outcome measure scores.

• #5 Physical prognostic factors predicting outcome following anterior cruciate ligament reconstruction: protocol for a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/10/3/e033429

  From these reviews, multiple factors have been identified which are associated with poorer outcome, such as being a smoker, preoperative quadriceps strength deficit of 20% or more, preoperative knee range of motion limitations (flexion), increased pain, ACL or knee laxity and concomitant meniscal injury. […] Predictors of successful outcome include male patients aged 30 years with normal body mass index (BMI) and the use of hamstring tendon autografts. […] These highlighted studies emphasise that there are numerous and wide-ranging potential physical prognostic factors that may predict outcomes following ACL reconstruction and that they can be grouped into either modifiable (eg, quadriceps strength) or non-modifiable factors (eg, age). […] The outcome of this work will be a summary of the evidence of physical prognostic factors predicting outcome following ACL reconstruction, which will include both modifiable and non-modifiable factors and their implications on recovery.

• #6 Physical prognostic factors predicting outcome following anterior cruciate ligament reconstruction: protocol for a systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7170562/

  Predictors of successful outcome include male patients aged 30 years with normal body mass index (BMI) and the use of hamstring tendon autografts. […] These highlighted studies emphasise that there are numerous and wide-ranging potential physical prognostic factors that may predict outcomes following ACL reconstruction and that they can be grouped into either modifiable or non-modifiable factors. […] The outcome of this work will be a summary of the evidence of physical prognostic factors predicting outcome following ACL reconstruction, which will include both modifiable and non-modifiable factors and their implications on recovery.

• #7 Functional outcomes after anterior cruciate ligament reconstruction: unravelling the role of time between injury and surgery, time since reconstruction, age, gender, pain, graft type, and concomitant injuries | BMC Sports Science, Medicine and Rehabilitat

  https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-023-00663-x

  Numerous individual, temporal, injury- and surgery-specific factors impact the functional capacity during rehabilitation, return to sports (RTS), and re-injury prevention after an anterior cruciate ligament (ACL) reconstruction. […] This multicentre cohort study evaluated the isolated and interactive contributions of time between injury and surgery, time since reconstruction, age, gender, pain, graft type, and concomitant injuries as to inertial sensor-assessed motor function after ACL reconstructions in multiple linear mixed model regressions. […] Several predictors such as time between injury and reconstruction, time since reconstruction, age, gender, pain, graft type, and concomitant injuries contribute to the individual courses of functional abilities of the reconstructed side after ACL reconstruction.

• #8 Functional outcomes after anterior cruciate ligament reconstruction: unravelling the role of time between injury and surgery, time since reconstruction, age, gender, pain, graft type, and concomitant injuries | BMC Sports Science, Medicine and Rehabilitat

  https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-023-00663-x

  Time since reconstruction, time between injury and reconstruction, age, gender, pain, graft type, and concomitant injuries are not independent but nested interrelating predictors of functional outcomes after anterior cruciate ligament reconstruction. […] It might not be enough to assess them isolated; the knowledge on their interactive contribution to motor function is helpful for the management of the reconstruction and individualized return to sports strategies. […] Function after anatomic ACL reconstruction is influenced by several interacting factors. […] We found that many contributors interactively impact on different functional abilities during the RTS-process after ACL reconstruction. […] Knowing these contributors, their contributive value (estimate), and their interaction is helpful for the function-based and deficit-oriented rating and management of rehabilitation and RTS strategies. […] Numerous factors such as time between injury and reconstruction, time since reconstruction, age, gender, pain, graft type, and concomitant injuries are predictive for the individual values and courses of functional abilities after ACL reconstruction.

• #9 Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI) Scores over Time After Anterior Cruciate Ligament Reconstruction: A Systematic Review with Meta-analysis | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-024-00712-w

  Psychological readiness is an important consideration for athletes and clinicians when making return to sport decisions following anterior cruciate ligament reconstruction (ACLR). […] To investigate psychological readiness (measured via the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI)) over time after ACL tear and understand if time between injury and surgery, age, and sex are associated with ACL-RSI scores. […] Overall, ACL-RSI scores were higher at 3 to 6 months post-ACLR (mean=61.5 [95% confidence interval (CI) 58.6, 64.4], I2=94%) compared to pre-ACLR (mean=44.4 [95% CI 38.2, 50.7], I2=98%), remained relatively stable, until they reached the highest point 2 to 5 years after ACLR (mean=70.7 [95% CI 63.0, 78.5], I2=98%). […] Psychological readiness to return to sport appears to improve early after ACL injury, with little subsequent improvement until 2-years after ACLR. Longer time from injury to surgery, female sex and older age might be negatively related to ACL-RSI scores 12-24 months after ACLR.

• #10 Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI) Scores over Time After Anterior Cruciate Ligament Reconstruction: A Systematic Review with Meta-analysis | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-024-00712-w

  Age, sex, and time from injury to surgery (i.e., treatment approach) appear prognostic for early ACL-RSI scores, but their prognostic ability diminishes for later ACL-RSI scores. […] The pooled ACL-RSI scores across all studies were higher at 3 to 6 months post-ACLR (pooled mean=61.5 [95% CI 58.6, 64.4]) compared to pre-ACLR (pooled mean=44.4 [95% CI 38.2, 50.7]). […] There is weak evidence that ACL-RSI scores improved from pre-ACLR to 3 to 6-months post-ACLR, but then remained constant until 2 to 5-years post ACLR, where they were the highest (~70/100). […] Older age, female sex and longer time from injury to surgery (days) may be associated with lower ACL-RSI scores 1 to 2 years after ACLR.

• #11 Differences in Biomechanical Determinants of ACL Injury Risk in Change of Direction Tasks Between Males and Females: A Systematic Review and Meta-Analysis | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-024-00701-z

  No differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. […] This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. […] Further research is required to identify if this translates to similar injury risk, considering morphological differences in strain characteristics between males and females. […] This finding also aligns with observational studies identifying limited knee flexion and dynamic knee valgus to be apparent features of non-contact ACL injury, particularly in females. […] Therefore, the evidence concerning differences in KJLs and injury risk between males and females remains contentious and requires further investigation.

• #12 Prediction of ACL Injuries from Vertical Jump Kinetics in Division 1 Collegiate Athletes | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/18819-prediction-of-acl-injuries-from-vertical-jump-kinetics-in-division-1-collegiate-athletes

  The purpose of this investigation was to identify whether the force-time variables from vertical jumps could predict ACL injuries in collegiate athletes. […] Significant differences between the ACL and healthy groups were seen for explode (p=0.08), drive (p=0.06), load:explode ratio (p=0.06), and explode:drive ratio (p=0.03. […] The vertical jump force plate variables were able to identify athletes who sustained an ACL injury within 66 days of testing. […] The kinetic variables collected from vertical jumps were able to identify athletes who later sustained an ACL injury, demonstrated by altered force-time variables.

• #13 Prognosis of anterior cruciate ligament reconstruction: a data-driven approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4991268/

  Individuals who suffer anterior cruciate ligament (ACL) injury are at higher risk of developing knee osteoarthritis (OA) and almost 50% display symptoms 10-20 years post injury. Anterior cruciate ligament reconstruction (ACLR) often does not protect against knee OA development. […] The proposed DDP algorithm facilitates hierarchical handling of the large dataset and can assess the state of recovery in post-ACLR conditions based on data collected from stair ascent and descent exercises of subjects. […] The DDP algorithm identifies inefficient knee varus motion and knee rotation as primary difficulties experienced by some of the post-ACLR population. In such cases, levels of energy dissipation rate at the knee, and its fluctuation may be used as measures for assessing progress after ACL reconstruction.

• #14 Prognosis of anterior cruciate ligament reconstruction: a data-driven approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4991268/

  The proposed DDP approach estimates the relevant constitutive parameters in situ. Instead of carefully designed training regimen, it can use any two time sequences of data. However, it only focuses on the situation at hand, rather than trying to master any general situation. […] The proposed DDP algorithm obviates the need for a priori off-line testing or training to extract the transitional statistics of the system. Instead of attempting to develop a capability for predicting system response under general conditions, it uses only online available data and short-term memory (minimum two time frames are needed) to develop a prognosticator specializing in the current situation or problem at hand and makes a prediction regarding incipient instability over a relatively short prediction horizon.

• #15 The Role of Artificial Intelligence in Anterior Cruciate Ligament Injuries: Current Concepts and Future Perspectives

  https://www.mdpi.com/2650760

  The remarkable progress in data aggregation and deep learning algorithms has positioned artificial intelligence (AI) and machine learning (ML) to revolutionize the field of medicine. […] AI is becoming more and more prevalent in the healthcare sector, and its impact on orthopedic surgery is already evident in several fields. […] The knee is involved in nearly half of all injuries in orthopedic sports pathology. Anterior cruciate ligament (ACL) tears are the most common injury among these, accounting for up to 78% of all sports-related knee pathology. […] Despite the ongoing debate in the literature regarding ACL reconstruction, encompassing various surgical techniques, graft and fixation devices, and rehabilitation approaches, the procedure is considered safe. […] In the management of ACL tears, AI and ML can play a role in improving diagnostics, accurately predicting individuals at risk of ACL injury or re-injury, identifying complex anatomic landmarks during surgery, and optimizing pain control and postoperative rehabilitation protocols.

• #16 Machine learning models predicting risk of revision or secondary knee injury after anterior cruciate ligament reconstruction demonstrate variable discriminatory and accuracy performance: a systematic review | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-024-08228-w

  Machine learning models designed to predict the risk of revision or secondary knee injury demonstrate variable discriminatory performance when evaluated with AUC or concordance metrics. […] Furthermore, there is variable calibration, with several models demonstrating evidence of miscalibration at two or five-year marks. […] A key limitation of this study is the lack of external validation of existing models, which restricts their generalizability. […] Future efforts should focus on validating current models in addition to developing and integrating multimodal neural networks to improve predictive accuracy and reliability.

• #17

  https://journals.lww.com/jbjsjournal/fulltext/2022/01190/predicting_anterior_cruciate_ligament.6.aspx

  Several factors are associated with an increased risk of anterior cruciate ligament (ACL) reconstruction revision. […] We sought to determine if machine learning analysis of the Norwegian Knee Ligament Register (NKLR) can identify the most important risk factors associated with subsequent revision of primary ACL reconstruction and develop a clinically meaningful calculator for predicting revision of primary ACL reconstruction. […] The data set included 24,935 patients, and 4.9% underwent a revision surgical procedure during a mean follow-up (and standard deviation) of 8.1 4.1 years. […] An in-clinic calculator was developed that can estimate the risk of ACL revision (Revision Risk Calculator). This calculator can quantify risk at a patient-specific level, with a plausible range from near 0% for low-risk patients to 20% for high-risk patients at 5 years.

• #18

  https://journals.lww.com/jbjsjournal/fulltext/2022/01190/predicting_anterior_cruciate_ligament.6.aspx

  The most important finding of this study was that machine learning analysis of a knee ligament register allows the creation of a validated algorithm to predict a patients risk of ACL reconstruction revision with moderate accuracy. […] Using this algorithm, an in-clinic calculator was developed that can estimate revision risk. […] For the clinician, the introduction of an easy-to-use calculator can guide the patient-specific discussion surrounding the surgical options and realistic outcome goals. […] The Cox Lasso model identified only 5 variables necessary to predict outcome, and the other 3 models either used more variables without an appreciable improvement in accuracy or had slightly lower accuracy overall. […] All 5 of the variables that were found to be important for outcome prediction have previously been identified as being associated with an increased risk of revision ACL reconstruction.

• #19

  https://journals.lww.com/jbjsjournal/fulltext/2022/01190/predicting_anterior_cruciate_ligament.6.aspx

  In conclusion, machine learning analysis of a national knee ligament register can predict the risk of ACL reconstruction revision with moderate accuracy. This supports the creation of an in-clinic calculator for point-of-care risk stratification based on the input of only 5 variables. Similar analysis using larger or more comprehensive data may improve the accuracy of risk prediction, and future studies incorporating patients who have experienced a failure of ACL reconstruction but have not undergone subsequent revision may better predict the true risk of ACL reconstruction failure.

• #20 The Role of Artificial Intelligence in Anterior Cruciate Ligament Injuries: Current Concepts and Future Perspectives

  https://www.mdpi.com/2650760

  This review aims to examine the literature that explores the comprehensive clinical relevance of AI-based tools utilized before, during, and after ACL reconstruction, specifically focusing on the use of AI, ML, and DL, also describing their conceptual differences. […] The exponential increase in studies on AI tools applicable to the management of ACL tears promises a significant future impact in its clinical application, with growing attention from orthopedic surgeons.

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