If anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed.

Cardiometabolic effects of physical exercise depend on its intensity, duration, and type. The aim of this study was to compare the effects of two exercise models, Nordic Walking (NW) and Pilates, on postmenopausal women. The study comprised 196 overweight or obese women: 20 were advised to maintain their previous level of physical activity (control group) whereas the others started either an NW exercise program (n = 88) or a Pilates exercise program (n = 88). Blood was collected twice for testing: before the program commenced and after it had ended. Of the 196 women who enrolled in the study, 147 (75%) completed the study; among those women, 69 (47%) completed a 10-week NW exercise program, 58 (39%) completed a 10-week Pilates exercise program, and 20 (14%) were in the control group. After 10 weeks, women in the NW group showed a significant reduction in body weight (6.4%), body mass index (6.4%), blood glucose (3.8%), total cholesterol (10.4%), non-high-density lipoprotein (HDL) cholesterol (16.7%), low-density lipoprotein cholesterol (12.8%), and triglycerides (10.6%), as well as an increase in HDL cholesterol (9.6%). Significantly smaller-although still favorable-changes, except for glucose and HDL cholesterol levels, were observed in the Pilates group (decreases of 1.7%, 1.7%, 1.6%, 5.3%, 8.3%, 7.5%, and 6% and an increase of 3.1%, respectively). Nevertheless, at the end of the study, the percentage of women with target concentrations of the lipid fractions had significantly increased in both exercise groups. No significant changes in the studied parameters were found in the control group. On multiple regression analysis, type of exercise program was an independent predictor of amplitude changes in most of the studied parameters. Exercise training in accordance with the NW model causes statistically and clinically more significant changes in glucose and basic blood lipid levels than do Pilates and dietary intervention alone.

The anterior cruciate ligament (ACL) is cited as the most frequently injured ligament in the knee. The standard treatment of ACL injury remains ligament reconstruction followed by a postoperative physiotherapeutic procedure. During the reconstruction, the torn ligament can be replaced with an autograft or an allograft. A synthetic ligament is also one of the available graft options. Synthetic grafts in ruptured ACL treatment have been used as scaffolds, stents, or prostheses. The story of using synthetic materials in ACL deficient knee treatment started in the beginning of the 20th century with the usage of silk and silver fibers. The second half of the 20th century abounded in new synthetic materials being proposed as torn ACL replacements, such as Supramid®, Teflon® or Dacron®, Proplast®, carbon fiber graft, ABC graft, Kennedy-LAD®, Trevia, Leeds-Keio, Gore-Tex®, PDS®, EULIT®, and Polyflex® or LARS®. Artificial ligaments have intrigued surgeons for all these years as they represent the hope for grafts that are easily available and stronger than soft tissue "off-the-shelf" grafts, simplifying the surgery, and avoiding graft harvesting and donor site morbidity. However, most of the artificial grafts have been characterized by high rates of failure. One of the very few synthetic grafts gaining more widespread popularity has been LARS®. However, it is suggested that the ligament not be considered as a potential graft for primary reconstruction of the ACL, and it should be rather treated as an alternative graft in special cases, so the optimal synthetic graft material remains controversial.

BACKGROUND:We investigated whether the duration of postoperative physiotherapy supervision by a physiotherapist affects clinical outcome, speed, and agility in males 8 months after anterior cruciate ligament reconstruction (ACLR). MATERIAL AND METHOD...

The aim of this paper is to present the physiotherapeutic program employed at the Rehabilitation Centre for the College of Physiotherapy in Wrocław, Poland and its effectiveness by demonstrating the increase in strength of knee joint extensor and flexor muscles of patients after anterior cruciate ligament (ACL) reconstruction. Thirty-seven males participated in the physiotherapeutic program from the first week up to 8 months postoperatively. Each patient underwent an individual therapeutic program. Endoscopic reconstruction of a completely ruptured ACL was performed using Mitek’s method (graft harvesting from flexor muscles). All patients previously underwent orthopedic and functional examinations, including measurements of the range of movement, knee and thigh circumference and strength of flexor and extensor muscles of the involved and uninvolved leg using a Biodex 3 System in both static and isokinetic modes. The outcome of the physiotherapeutic procedure, which is detailed in the paper, revealed a favorable effect of physiotherapy 6 months after ACL reconstruction. The observed 9% deficit in extensor muscle strength measured under isokinetic conditions of the involved knees compared with the uninvolved knees led us to conclude that the period of physiotherapy should be extended beyond 6 months for some patients. 1. Six months of physiotherapy following ACL reconstruction in males favorably affected muscle strength values of the involved and uninvolved knees under static and isokinetic conditions. 2. The application of individual loads during the sixth month of physiotherapy resulted in similar values of extensor and flexor muscle strength measured under static conditions, and flexor muscle strength measured under isokinetic conditions in involved and uninvolved knees.