Knie-artrose

Fietsen verstandig?

Feit

Bij hardlopen wordt de knie belast met 6x uw lichaamsgewicht bij elke stap

Máxima Medisch Centrum

Value-Based Health Care

ESSKA Accredited Teacher

Orthopedie Groot Eindhoven

Goede uitleg is essentieel voor juiste keuze behandeling

Meniscus-scheur

Voorste kruisbandreconstructie

Achterste kruisbandletsel

Zorg op maat

YouTube kanaal dr RPA Janssen

Internationaal wetenschappelijk onderzoek

Kruisbandoperaties knie

RPA Janssen MD PhD

Kruisbandoperaties

Waardegedreven zorg

Last van knie-artrose?

Spreekuur / Policlinique / Outpatient clinic

Nederlandse Vereniging voor Arthroscopie

Máxima Medisch Centrum

Kruisbandoperaties bij kinderen

Veel pijn bij ernstige knie-artrose?

Samen met uw arts gekozen voor een knie-operatie?

Eenzijdige knie-artrose knie en actief leven?

Máxima Medisch Centrum Eindhoven-Veldhoven

Kwaliteit van leven

Samen kiezen voor de beste behandeling

Sporten met plezier

Oplossingen voor de lange termijn

Associate Professor Knee Reconstruction

Fact

Kneecap pain is a regular occurrence in fitness knee rehabilitation

Knee osteoarthritis

Cycling wise?

Fact

When running, the knee is loaded with 6x your body weight with each step

Steigerung der Evidenz zur optimalen Behandlung kindlicher VKB-Verletzungen: Die Initiative zur Erfassung von Verletzungen des vorderen Kreuzbandes bei Kindern und Jugendlichen (Paediatric Anterior Cruciate Ligament Monitoring Initiative, PAMI)

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Mouton, C., Magosh, A., Moksnes, H., Janssen, R. P. A., Fink, C., Zaffagnini, S., Monllau, J. C., Ekås, G., Engebretsen, L., Nührenbörger , C., & Seil, R
Sports Orthopaedics and Traumatology. 2022, Published Online Nov 30
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Anterior cruciate ligament reconstruction with hamstring tendon autograft and accelerated brace-free rehabilitation: a systematic review of clinical outcomes

Janssen RPA, Melick v N, Mourik v JBA, Reijman M, Rhijn v LW
BMJ Open Sport Exerc Med. 2018 Apr 9;4(1):e000301. doi: 10.1136/bmjsem-2017-000301. eCollection 2018

ABSTRACT

OBJECTIVE: To investigate the clinical outcomes after hamstring tendon autograft ACL reconstruction with accelerated, brace-free rehabilitation.

DESIGN: Systematic review according to PRISMA guidelines.

DATA SOURCES: Embase, Medline Ovid, Web of science, Cochrane CENTRAL and Google scholar from 1-1-1974 till 31-1-2017.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Study designs reporting outcomes in adults after arthroscopic, primary ACL reconstruction with hamstring autograft and accelerated, brace-free rehabilitation.

RESULTS: Twenty-four studies were included in the review. After hamstring tendon autograft ACL reconstruction with accelerated brace-free rehabilitation: (a) Early start of open kinetic exercises at 4 weeks in a limited range of motion (90°-45°) and progressive concentric and eccentric exercises from 12 weeks did not alter outcomes; (b) Gender and age did not influence clinical outcomes; (c) Anatomic reconstructions showed better results than non-anatomic reconstructions; (d) There was no difference between single- and double-bundle reconstructions; (e) Femoral and tibial tunnel widening occurred; (f) Hamstring tendons regenerated after harvest and (h) Biological knowledge did not support return to sports at 4-6 months.

CONCLUSIONS: After hamstring tendon autograft ACLR with accelerated brace-free rehabilitation, clinical outcome is similar after single- and double-bundle ACLR. Early start of open kinetic exercises at 4 weeks in a limited range of motion (90°-45°) and progressive concentric and eccentric exercises from 12 weeks post surgery do not alter clinical outcome. Further research should focus on achievement of best balance between graft loading and graft healing in the various rehabilitation phases after ACLR as well as validated, criterion-based assessments for safe return to sports.

LEVEL OF EVIDENCE: 2b; therapeutic outcome studies

KEYWORDS: hamstring autograft, ACL reconstruction, accelerated rehabilitation, clinical outcomes, graft remodelling