Best practice for primary isolated ACL reconstruction.

A consensus statement of best management in primary ACL rupture, provided by the British Orthopaedic Association.

Full text available 

All rights reserved to the British Orthopaedic Association.

MSc Thesis: Biomechanical and neuromuscular adaptations in those with ACL reconstruction during functional movements.

MSc thesis by Michelle Hall from the Iowa State University, looking at lower extremity gait patterns of those with ACL reconstruction (>1yr) and in healthy controls with specific focus to determine if factors associated with the development and/or progression of knee OA were observed in ACL reconstructed individuals when compared to healthy counterparts.

Full text available. 

All rights reserved to Michelle Hall.

PhD Thesis: The significance of pain in knee joint loading during walking

PhD thesis by Marius Henriksen from the Aalborg University, exploring association between knee pain and biomechanics of the walking gait in knee OA patients. Specifically, he aims to compare knee joint loading in OA and healthy subjects. Moreover, he evaluates the effect of local pain relief on knee joint loading in OA patients. Finally, author determines the effect of experimental quadriceps muscle pain on knee joint loading in healthy controls. 
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All rights reserved to Marius Henriksen.

AAOS ''Treatment of Osteoarthritis of the Knee”: Summary of recommendations.

This summary contains a list of the evidence based treatment recommendations for knee OA and includes only less invasive alternatives to knee replacement. Full text available.

I have summarized it and listed specific interventions with strenght of evidence provided. 

1. Exercise – strong evidence for effectiveness
2. NSAIDs – strong evidence for
3. Acupuncture – strong evidence against
4. Glucosamine and chondroitin – strong evidence against
5. Hyaluronic acid injections – strong evidence against
6. Arthroscopy with lavage and debridement – strong evidence against
7. Weight loss – moderate evidence for
8. Needle lavage – moderate evidence against
9. Lateral wedge insoles – moderate evidence against
10. Physical agents (TENS, ultrasound, etc.) – inconclusive
11. Manual therapy (chiropractic, massage) – inconclusive
12. Valgus-directing force brace – inconclusive
13. Acetaminophen, opioids, pain patches – inconclusive 
14. Intraarticular corticosteroid injections – inconclusive
15. Growth factor injections and/or platelet-rich plasma – inconclusive
16. Partial meniscectomy in osteoarthritis patients with torn meniscus – inconclusive
17. Valgus-producing proximal tibial osteotomy – limited evidence
18. Free-floating interpositional device – no evidence; consensus against

PhD thesis: Improving conservative treatment of knee and hip osteoarthritis.

PhD thesis by Gijs Snijders from Radboud University Nijmegen. The thesis focuses on better use  of existing conservative treatment and study possible new treatment targets in the conservative treatment of knee and hip OA.

All rights reserved to Gijs Snijders.

Full text available.

Phd thesis: Patellofemoral Pain Syndrome and Exercise Therapy.

Phd thesis by Robbart van Linschoten from Erasmus University in Rotterdam, NL, investigating clinical effects and cost effectiveness of exercise therapy for patellofemoral pain syndrome as well as studying the effectiveness of exercise therapy in relation to other conservative strategies.

Full text available.

All rights reserved to Robbart van Linschoten.

Terminology and classification of muscle injuries in sport: The Munich consensus statement.

Terminology and classification of muscle injuries in sport: The Munich consensus statement.
Mueller-Wohlfahrt, H., Haensel, L., Mithoefer, K., Ekstrand, J., English, B., McNally, S., Orchard, J., Niek van Dijk, C., Kerkhoffs, G., Schamasch, P., Blottner, D., Swaerd, L., Goedhart, E. and Ueblacker, P. British Journal of Sports Medicine, 2012.
Full text available.
All rights reserved to the British Journal of Sports Medicine.

OARSI recommendations for the management of hip and knee osteoarthritis.

OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines.
Zhang, W., Moskowitz, R., Nuki, G., Abramson, S., Altman, R., Arden, N., Bierma-Zeinstra, S., Brandt, K., Croft, P., Doherty, M., Dougados, M., Hochberg, M., Hunter, D, Kwoh, K. Lohmander, L. and Tugwell, P. Osteoarthrits and Cartilage, 2008; 16: 137 - 162.
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OARSI recommendations for the management of hip and knee osteoarthritis Part III: changes in evidence following systematic cumulative update of research published through January 2009.
Zhang, W., Nuki, G., Moskowitz, R., Abramson, S., Altman, R., Arden, N., Bierma-Zeinstra, S., Brandt, K., Croft, P., Doherty, M., Dougados, M., Hochberg, M., Hunter, D, Kwoh, K. Lohmander, L. and Tugwell, P. Osteoarthrits and Cartilage, 2010; 18: 476 - 499.
Full text available

All rights reserved to the Osteoarthritis and Cartilage.

ACL tear treatment guidelines for adolescents.

Anterior Cruciate Ligament Injuries in the Skeletally Immature Athlete: Diagnosis and Management. 
Frank, J. and Gambacorta, P. Journal of the American Academy of Orthopaedic Surgeons, 2013; 21 (2). 
http://www.jaaos.org/content/21/2/78

ACL injuries among children and adolescents start to occur more frequently compared to the past. Lack of consensus has been present in regards to diagnosis and management. For that reason, authors decided to put together a review article on the management of the ACL ruptures in active children and adolescents.
According to authors ACL tear in this group of patients requires special consideration and treatment to ensure appropriate healing and prevention of long – term complications such as: meniscal lesions, cartilage defects and early osteoarthritis development.  To avoid this, authors outline potential strategies for treating pediatric ACL injuries. 

Guidelines on knee OA treatment approaches.

American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee.
Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, & Tugwell P. Arthritis Care & Research, 2012; 64, 465-74.
Full text available
All rights reserved to the Arthritis Care & Research.

Guideline on ACL injury.

Guideline on anterior cruciate ligament injury. A multidisciplinary review by the Dutch Orthopaedic Association

Meuffels D., Poldervaart M., Diercks R., Fievez A., Patt T., van der Hart C., Hammacher E., van der Meer F., Goedhart E., Lenssen A., Muller-Ploeger S., Pols M., Saris D. Acta Orthopaedica; 2012, 83, 379–386.

Full text available

The guidelines answer eight clinical questions:

“1. What is the role of physical examination and additional diagnostic tools?

2. Which patient-related outcome measures should be used?

3. What are the relevant parameters that influence the indication for an ACL reconstruction?

4. Which findings or complaints are predictive of a bad result of an ACL injury treatment?

5. What is the optimal timing for surgery for an ACL injury?

6. What is the outcome of different conservative treatment modalities?

7. Which kind of graft gives the best result in an ACL reconstruction?

8. What is the optimal postoperative treatment concerning rehabilitation, resumption of sports, and physiotherapy?”
All rights reserved to the Acta Orthopaedica.