A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

Koji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL) injuries, we do not understand which options could potentially prev...

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Autores principales:	Duncan KJ, Chopp-Hurley JN, Maly MR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Exercise therapy Knee Ligament articular Osteoarthrosis Rehabilitation Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/03ce3ca0087b4f979a18c02ade8ec0e3
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spelling	oai:doaj.org-article:03ce3ca0087b4f979a18c02ade8ec0e32021-12-02T02:31:00ZA systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?1179-156Xhttps://doaj.org/article/03ce3ca0087b4f979a18c02ade8ec0e32016-01-01T00:00:00Zhttps://www.dovepress.com/a-systematic-review-to-evaluate-exercise-for-anterior-cruciate-ligamen-peer-reviewed-article-OARRRhttps://doaj.org/toc/1179-156XKoji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL) injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA). The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods: Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database) databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results: Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11). Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations: This review was not registered through PROSPERO. Conclusion: The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing clinical guidelines for ACL injury management. Keywords: exercise therapy, knee, ligament, articular, osteoarthrosis, rehabilitationDuncan KJChopp-Hurley JNMaly MRDove Medical PressarticleExercise therapyKneeLigamentarticularOsteoarthrosisRehabilitationDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2016, Iss Issue 1, Pp 1-16 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Exercise therapy Knee Ligament articular Osteoarthrosis Rehabilitation Diseases of the musculoskeletal system RC925-935
spellingShingle	Exercise therapy Knee Ligament articular Osteoarthrosis Rehabilitation Diseases of the musculoskeletal system RC925-935 Duncan KJ Chopp-Hurley JN Maly MR A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?
description	Koji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL) injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA). The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods: Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database) databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results: Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11). Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations: This review was not registered through PROSPERO. Conclusion: The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing clinical guidelines for ACL injury management. Keywords: exercise therapy, knee, ligament, articular, osteoarthrosis, rehabilitation
format	article
author	Duncan KJ Chopp-Hurley JN Maly MR
author_facet	Duncan KJ Chopp-Hurley JN Maly MR
author_sort	Duncan KJ
title	A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?
title_short	A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?
title_full	A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?
title_fullStr	A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?
title_full_unstemmed	A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?
title_sort	systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/03ce3ca0087b4f979a18c02ade8ec0e3
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A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

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