Jump tests are simple, quick to execute, and considered the most reliable tool to measure lower extremities power and explosiveness in athletes. Wearable inertial sensors allow the assessment of jumping performance on any surface. The validity of inertial sensors measurements is a pivotal prerequisite to reliably implement their utilization in the clinical practice. Twenty-seven athletes (20 M/7 F, age: 27 ± 7 years old) performed five double-leg countermovement jumps (CMJs) and three single-leg CMJs per side with their hands on their hips. Jump height was measured/computed simultaneously with the optoelectronic system, force platforms, and the Baiobit inertial sensor system. The athletes completed the international physical activity questionnaire (IPAQ). When comparing the methods (Baiobit vs. force platforms), a non-statistically significant bias of 1.8 cm was found for two-leg CMJs and −0.6 cm for single-leg CMJs. The intraclass correlation coefficients (ICCs) was “excellent” for double-leg CMJs (ICC = 0.92, 95% CI = 0.89–0.94) and “good” for single-leg CMJs (ICC = 0.89, 95% CI = 0.85–0.91). When comparing the methods (Baiobit vs. force platforms + optoelectronic system), a non-statistically significant bias of −0.9 cm was found for two-leg CMJs and −1.2 cm for single-leg CMJs. The intraclass correlation coefficient (ICC) was “good” for both double-leg CMJs (ICC = 0.80, 95% CI = 0.73–0.85) and for single-leg CMJs (ICC = 0.86, 95% CI = 0.80–0.89). Baiobit tends to overestimate double- and single-leg CMJ height measurements; however, it can be recommended in the world of rehabilitation and sport analysis.

Objective: The aim of this meta-analysis was to investigate whether home-based physical therapy (HPT) is as safe and effective as the conventional inpatient/outpatient physical therapy (CPT) after total knee arthroplasty (TKA). Methods: Three databases (PubMed, Web of Science, and Cochrane) were systematically searched on 8 January 2024. Randomized controlled trials (RCTs) comparing HPT with CPT following TKA were included. The outcomes included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), 6 min walking test, range of motion (ROM), 36-Item Short Form Survey (SF-36), and visual analogue scale (VAS) for pain, and were analyzed at short-term (≤12 weeks) and mid/long-term follow-ups (>12 weeks). Results: Twenty RCTs (3706 patients) were included. Both groups experienced significant improvements, but no differences emerged when comparing all analyzed outcomes. WOMAC improvement was 36.2 points with HPT (p < 0.0001) vs. 39.2 with CPT (p < 0.0001); KOOS increased by 24.8 points with HPT (p < 0.0001) vs. 25.2 points with CPT (p < 0.0001); OKS improved by 16.1 points with HPT (p < 0.0001) vs. 16.3 points with CPT (p < 0.0001); ROM improved by 6.3° with HPT (p = n.s.) vs. 7.7° with CPT (p = 0.029); SF-36 improved by 3.3 points with HPT (p = n.s) vs. 7.4 points with CPT (p = n.s.); and VAS pain decreased by 2.5 points with HPT (p < 0.0001) vs. 3.0 points with CPT (p < 0.0001). Conclusions: HPT is a valid option for the post-operative rehabilitation of patients undergoing TKA, leading to results similar to CPT. This questions the need for a more complex and expensive management of these patients, considering the additional HPT benefits of healthcare cost reductions, early patient discharge, and less in-person physical therapy sessions, with equal patient final satisfaction. While this review offers a comprehensive representation of numerous studies, the research underlines significant heterogeneity in the reported data, thereby diminishing the overall robustness of the analysis, and future studies are needed to confirm the study results.

Meniscus injuries occur in physically active individuals, as well as members of the general population,^1-4 with annual incidence rates of 66 to 70 per 100 000 persons reported.^5-7 Meniscectomies are a primary risk factor for knee osteoarthritis,^8-13 which led to efforts toward developing solutions to preserve or restore as much meniscal tissue as possible.^14-18 Unfortunately, surgical intervention is not always avoidable, and arthroscopic isolated meniscectomy (AM) remains one of the most commonly performed orthopedic procedures.^19,20

Background: Anterior cruciate ligament reconstruction (ACLR) is the preferred treatment for ACL rupture. Medial hamstring (HS) tendons are the most common autografts. An abnormal mediolateral HS muscle activation pattern after ACLR with an HS autograft could influence return to sport (RTS). Purpose: To evaluate patients who underwent ACLR with concurrent isokinetic tests and surface electromyography (sEMG) of the medial versus lateral HS compared with a group of healthy controls to identify potential abnormal patterns at RTS. Study Design: Comparative study; Level of evidence, 3. Methods: The mean medial versus lateral HS sEMG amplitude and timing were measured during isokinetic tests at 60, 180, and 300 deg/sec in 92 participants: 46 patients who underwent primary HS-grafted ACLRs (ACLR group) and 46 healthy controls matched for age (18-45 years), sex, and level of physical activity (Tegner, 4-9) (control group). After the 8th postoperative month, the ACLR group were evaluated with an isokinetic test combined with sEMG of the medial and lateral HS. The control group were tested with the same procedure. sEMG data were included only if the minimum criteria for RTS were met according to the published literature (HS/quadriceps ratio ≥60% and quadriceps and HS interlimb peak torque difference at 60, 180, and 300 deg/sec ≤10%). Results: There was no difference in isokinetic peak torque normalized to body mass between ACLRs and controls at any tested angular velocity. The mean sEMG amplitude for both the medial and lateral HS showed no between-group difference at 60, 180, and 300 deg/sec. No intergroup differences emerged for the mediolateral HS ratio during all tests. Instead, the mean sEMG time-to-peak for the medial HS was consistently faster in the ACLR group ( P = .02 at 60 deg/sec; P = .01 at 180 deg/sec; P = .04 at 300 deg/sec), with no intergroup difference for the lateral HS at 60, 180, 300 deg/sec. Conclusion: The grafted medial HS showed consistently faster sEMG time-to-peak in the ACLR group than in the control group at all tested velocities. No differences emerged on sEMG amplitude for the medial HS and on both sEMG amplitude and timing for the lateral HS. Those who underwent HS-grafted ACLR showed a higher neuromuscular demand on the grafted medial HS at RTS. This altered overall HS muscle coordination could affect lower limb biomechanics during active movements, potentially increasing the risk of ACL reinjury.

Rupture of the anterior cruciate ligament (ACL), the primary stabilizing ligament of the knee joint, is one of the most significant problems in orthopaedic sports medicine with an annual incidence of 71 to 91 per 100,000 persons reported in some European Union (EU) countries (Granan et al, 2009). Taking the population of the EU countries as 500,000,000 the annual incidence of ACL ruptures equates to approximately 450,000 per year in the EU, with an associated approximate direct medical cost of > €4 billion. This cost estimate does not take into account further economic sequelae such as lost productivity and medical costs associated with the development of post-traumatic knee joint osteoarthritis (OA). For athletes aiming to return-to-sport after ACL rupture, ACL reconstruction (ACL-R) is the recommended treatment of choice. The aim of ACL-R is to maximise the stability and functional capacity of the ACL-deficient knee, with an objective of facilitating return-to-sport. Clearance for return-to-sport indicates the medical team’s confidence in the athlete’s ability to participate in sporting activities that place large demands on knee joint sensorimotor control. However, the prevalence of ACL re-ruptures following primary ACL-R is increasing worldwide (Wright et al, 2011; Ratzlaff et al, 2010) with a prevalence of 6% to 25% being reported (Myklebust et al, 1997; Grassi et al., 2017). A conservative estimate of a re-rupture rate of 11.5% this would mean that there would be > 40,000 ACL re-ruptures per year in the EU, equating to an annual direct operative cost of €400,000,000. Surgical intervention and postoperative rehabilitation program concur to the final outcome following ACL-R, therefore they should both be evaluated. While details of different surgical ACL-R procedures and grafts options have been extensively described and weighted in the literature, postoperative rehabilitation protocols are poorly described; their actual level of replicability is unclear. Physical therapy following ACL-R is key to re-establish the pre-operative functional abilities and recover from the insult to the whole joint and lower limb complex associated with the combination of the initial injury and surgical procedure. This takes place with a peculiar neuromuscular control re-training, regaining the different muscle strength sub-components, functional stability, balance, psychological readiness through repetitively practicing sports-specific/athletic movements in a progressive ecologically valid environment, and testing for return to sport to eventually minimize the risk for re-injury. Regardless the recognized pivotal role of post-surgical rehabilitation, yet paradoxically there is no universally accepted rehabilitation paradigm following ACL-R which pinpoints the cornerstones of such a long and crucial journey. Despite multiple publications on this topic, studies are characterized by an average poor level of reporting possibly invalidating the possibility to replicate programs. The aggregation of data on this topic could establish whether there’s a sufficient and consistent level of evidence to guide practicing clinicians in replicating a postoperative rehabilitation protocol for patients following ACL-R or there’s need for further and more solid clinical research in order to empower clinicians to implement a solid Evidence-Based Practice after ACL-R. The study protocol (PRISMA-P) and a protocol table following Arksey & O’Malley (2005) and Levac et al (2010) have been completed.