“Would you continue to drive your car around on a flat tire?”


Images © Dubai Bone & Joint


Double bunDle vs. single bunDle ACl reConstruCtion This is a controversial area, however there are some very good studies showing that the double bundle reconstruction may indeed be better in the following ways: re-creating more normal anatomy, better knee kinematics, and less likely to fail as compared to single bundle anatomic hamstring ACL reconstruction. This question will be answered in the near future.


rehAbilitAtion Another important area for debate, but most would agree that a balanced approach utilizing closed chain (foot position fixed throughout exercise) and protected open chain, as well as balance and


leArn more


Dr Murrell is speaking on the subject of ‘Anatomic ACL Reconstruction’ at the Pan-African Orthopaedics Conference at the Africa Health Exhibition & Congress taking place in Johannesburg, South Africa on 9-11th


May 2012. To find out more,


or to book your place as a delegate on this conference, please visit the website www.africahealthexhbition.com


042 ARAB HEALTH MAGAZINE ISSUE 2 2012


coordination types of rehabilitation programme are important for good functional outcomes. Bracing is an area that has very good literature. Knee


immobilization immediately following surgery for up to three weeks has been show to be beneficial, however, beyond this, bracing has not shown much benefit.


outComes AnD outCome Assessments It is difficult to know where one is going, if it is not known where someone is coming from. From this standpoint, both objective and patient completed subjective assessments are key to ensure the best possible outcomes. Some of the objective measurements include KT-1000, isometric, isokinetic, and functional testing. Some examples of subjective measurements include IKDC, KOOS, Modified Cincinnati, and Tegner-Lysholm scores. Even with all these measures, we are discovering that we are not as good as we think, and that for the highest demand athletes, the return to play at very high levels of competition after ACL reconstruction can be somewhere around 50-70%. To compound this, we are also seeing significant, albeit low levels, of patients who develop premature ar thritis when they should not. This is challenging our understanding of the very reasons why we are performing the surgery in the first place.


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