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Review of Current ACL Graft Choices and Recommendations for Improved Graft and Repair Mechanisms

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Ruptures in the anterior cruciate ligament are a prevalent injury, particularly in young athletes. This injury is frequently treated with surgical repair utilizing autologous tissue, cadaver allografts or synthetic grafts. However there is no definitive answer on which is the

Ruptures in the anterior cruciate ligament are a prevalent injury, particularly in young athletes. This injury is frequently treated with surgical repair utilizing autologous tissue, cadaver allografts or synthetic grafts. However there is no definitive answer on which is the best graft option. This review aims to compare clinical results of patellar tendon autograft (PT), hamstring autograft (HT), cadaver allograft and LARS synthetic ligament in ACL reconstruction. The ASU library was systematically searched for comparison studies or meta-analyses that compared or described ACL reconstruction graft options. The results of the studies were analyzed according to re-tear rate, return to pre-injury level of activity, KT-1000 laxity scores, post-operative muscle strength, International Knee Documentation Committee Score (IKDC), Lysholm score, Lachman test and donor site morbidity. Allografts showed the highest re-tear rate and increase in laxity when compared with the PT autograft and HT autograft. PT autograft provided the most stability according to the KT-1000 results. Knee extensor muscle strength was not graft dependent, but knee flexor strength decreased significantly in HT autograft patients. All grafts showed comparable results for IKDC, Lysholm scores and Lachman tests. There was increased anterior knee pain in PT autograft patients however this did not seem to have an affect on the stability or durability of the graft. The PT autograft is the best choice for individuals undergoing ACL reconstruction on the basis of lower re-tear rates and greater joint stability.

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Date Created
2015-05

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DIFFERENCES IN UNILATERAL CHEST PRESS MUSCLE ACTIVATION ON A STABLE VERSUS UNSTABLE SURFACE WHILE HOLDING ONE VERSUS TWO DUMBBELLS

Description

Training the bench press exercise on a traditional flat bench does not induce a level of instability as seen in sport movements and activities of daily living. Because of this, many new types of equipment have been created in an

Training the bench press exercise on a traditional flat bench does not induce a level of instability as seen in sport movements and activities of daily living. Because of this, many new types of equipment have been created in an attempt to induce instability, such as the COR Bench. 15 males and 7 females between the ages of 18 and 30 were recruited for the present study, which tested two forms of instability: using one dumbbell rather than two, and lifting on the COR bench compared to a flat bench. Thusly, EMG was used to measure muscle activity in four separate conditions of unilateral bench press movements: on a flat bench with one dumbbell, on a flat bench with two dumbbells, on the COR Bench with one dumbbell, and on the COR Bench with two dumbbells. Results indicated that lifting with one dumbbell compared to two dumbbells on the flat bench significantly increased muscle activity across all four muscles being analyzed (pectoralis major, p = .005; middle trapezius, p = .008; external obliques, p = .004; and internal obliques, p = .003), but lifting with one dumbbell compared to two dumbbells on the COR Bench only significantly increased muscle activity in the middle trapezius (p = .001), external obliques(p = . 032), and internal obliques (p = .001). The only muscle to exhibit a significant increase in muscle activity when going from one dumbbell on the flat bench to one dumbbell on the COR Bench was the middle trapezius (p = .010). These results imply that the COR Bench itself does not increase muscle activity as much as switching from two dumbbells to one dumbbell, regardless of the bench being used.

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Date Created
2013-12