Factors for Optimal ACL Surgery Outcome

As a patient of Vertex, you may be considering or have already undergone ACL surgery. Understanding the evidence-based factors that can determine your optimal long-term outcome after surgery is important for your recovery and rehabilitation process.

One of the most important factors to consider is the choice of graft material for ACL reconstruction. Autografts such as hamstring tendons, bone-patellar tendon-bone, and quadriceps tendon have been shown to have better outcomes compared to allografts. Additionally, a well-structured rehabilitation protocol that focuses on regaining range of motion, strength, proprioception, and neuromuscular control is crucial for optimal long-term outcomes. Your physical therapist at Vertex can work with you to create a personalized rehabilitation plan that suits your needs.

Age, knee extension (hyperextension is optimal), cross-sectional size of the graft, associated injuries, surgical technique, and rehabilitation protocol are also important factors to consider. It is essential to have an open and honest conversation with your surgeon about these factors and how they may impact your long-term outcome.

When it comes to finding information online, it can be overwhelming to navigate through the sea of information available. At Vertex, we prioritize evidence-based practice and aim to provide you with the most up-to-date and accurate information. References used in this blog post include:

By staying informed and actively participating in your recovery process, you can increase your chances of achieving an optimal long-term outcome after ACL surgery. Our team of experts is dedicated to providing you with the highest quality care and support throughout your recovery journey.

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Understanding the Revascularization Phase After ACL Reconstruction Surgery: What You Need to Know

After ACL reconstruction surgery, the body goes through a healing process that includes a phase called revascularization. During this phase, the body forms new blood vessels in the graft used to reconstruct the damaged ACL. This helps to provide nutrients and oxygen to the graft, which is important for its successful integration into the body.

The revascularization phase typically starts around the fourth week after surgery and continues for up to 12 weeks. During this time, there is an increase in cellular activity and changes in the extracellular matrix, which leads to the lowest mechanical properties of the reconstructed ACL graft. The graft necrosis releases growth factors that stimulate cell migration, proliferation, and extracellular matrix synthesis, which results in revascularization of the graft.

During the first few weeks of the revascularization phase, patients will work on gentle range of motion exercises to keep their knee mobile and reduce swelling. They should avoid high-impact activities, such as running or jumping, and follow their rehabilitation plan closely to avoid re-injury or complications that could require additional surgeries and prolonged rehabilitation.

As the revascularization phase progresses, the physical therapist will gradually introduce more challenging exercises and activities into the rehabilitation program. Patients may also begin to work on strength training exercises to help rebuild muscle around the knee.

It’s important to be patient during the revascularization phase and not rush the healing process. Patients should follow their physical therapist’s instructions carefully and communicate any concerns or questions they may have about their rehabilitation plan.

At Vertex, we specialize in ACL rehabilitation and have years of experience helping patients recover from ACL injuries. Our team of physical therapists will work closely with you to create an individualized rehabilitation plan that is tailored to your needs and goals. We’ll guide you through each phase of the rehabilitation process, including the revascularization phase, to help you achieve a safe and successful recovery.

In conclusion, the revascularization phase is an important part of ACL rehabilitation that requires patience and adherence to a rehabilitation plan. At Vertex, we are here to help guide you through each step of the rehabilitation process and ensure that you achieve the best possible outcome.

Reference:
Sawyer GA, Anderson BC, Christiansen BA. The Revascularization Phase of Tendon and Ligament Healing and its Relationship with Fibrosis. Curr Rheumatol Rep. 2021 Feb 10;23(3):16. doi: 10.1007/s11926-021-00972-y. PMID: 33566233.

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Post-Operative Nutrition: Optimizing Soft Tissue Healing and Promoting Collagen Synthesis

After surgery, it is crucial to provide the body with the necessary nutrients and vitamins to promote optimal healing. Adequate nutrition can reduce inflammation, speed up the recovery process, and support tissue regeneration. In this blog post, we will explore the importance of post-operative nutrition in optimizing soft tissue healing and promoting collagen synthesis, with recommended serving sizes.

Collagen is an essential protein for the structure and strength of various tissues in the body, including tendons, ligaments, and skin. After surgery, collagen synthesis plays a crucial role in the healing process. A balanced diet that includes essential nutrients such as protein, vitamin C, vitamin A, zinc, and copper can help support collagen synthesis and promote tissue healing.

Let’s take the example of an ACL reconstruction, a surgical procedure that repairs or replaces a torn anterior cruciate ligament in the knee. The ACL is a crucial ligament that provides stability to the knee joint. After surgery, the body requires adequate nutrition to support soft tissue healing and collagen synthesis, which is crucial for the success of the surgery and long-term knee function.

Here are some specific nutrients that can aid in the healing process after an ACL reconstruction, with recommended serving sizes:

  1. Protein is the building block of collagen and is essential for tissue repair and regeneration. Adequate protein intake can also help reduce inflammation and support muscle recovery. For adults, the recommended daily intake is at least 1 gram per pound of body weight. Good sources of protein include a 3-ounce serving of chicken (21 grams), a 3-ounce serving of salmon (22 grams), a cup of cooked lentils (18 grams), or a cup of Greek yogurt (23 grams).
  2. Vitamin C is crucial for collagen synthesis and plays a crucial role in soft tissue healing. The recommended daily intake for adults is 75-90 milligrams. Good sources of vitamin C include a medium orange (70 milligrams), a cup of strawberries (89 milligrams), a cup of broccoli (81 milligrams), or a cup of red bell pepper (152 milligrams).
  3. Vitamin A is involved in the growth and repair of soft tissues and can help support wound healing. The recommended daily intake for adults is 700-900 micrograms of retinol activity equivalents (RAE). Good sources of vitamin A include a medium sweet potato (2190 micrograms of RAE), a medium carrot (509 micrograms of RAE), a cup of spinach (573 micrograms of RAE), or 3 ounces of beef liver (6,582 micrograms of RAE).
  4. Zinc is a mineral that is essential for tissue growth and repair. It also plays a role in collagen synthesis and immune function. The recommended daily intake for adults is 8-11 milligrams. Good sources of zinc include a 3-ounce serving of oysters (74 milligrams), 3 ounces of beef chuck roast (7 milligrams), a cup of chickpeas (2.5 milligrams), or a cup of pumpkin seeds (6.6 milligrams).
  5. Copper is a mineral that is essential for collagen synthesis and connective tissue health. The recommended daily intake for adults is 900 micrograms. Good sources of copper include 3 ounces of beef liver (15.2 milligrams), 3 ounces of cooked crab (0.6 milligrams), a cup of cooked lentils (0.5 milligrams), or a cup of sunflower seeds (0.5 milligrams).

In addition to these nutrients, it is essential to stay hydrated and consume enough calories to support the body’s energy needs during the recovery process. One way to ensure adequate hydration is to drink at least half of your body weight in ounces of water per day. For example, if you weigh 150 pounds, aim for at least 75 ounces of water per day.

Remember to also consume enough calories to meet your body’s energy needs based on your age, gender, weight, and activity level. Consuming too few calories can hinder the healing process and delay recovery. Aim to eat a balanced diet that includes a variety of whole foods, such as fruits, vegetables, lean proteins, whole grains, and healthy fats.

In summary, post-operative nutrition is essential for optimizing soft tissue healing and promoting collagen synthesis. By including adequate amounts of protein, vitamin C, vitamin A, zinc, and copper in your diet, along with staying hydrated and consuming enough calories, you can support tissue repair and regeneration after surgery. Consult with a registered dietitian or healthcare professional if you have any questions or concerns about your post-operative nutrition.

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LISS Training

LISS, or Low-Intensity Steady-State, training is a form of cardiovascular exercise that involves performing low-impact movements at a steady pace for an extended period of time. LISS exercises include walking, cycling, swimming, or using the elliptical machine. It is a low-intensity form of cardio that is excellent for improving cardiovascular health, burning calories and fat, and is joint-friendly. Here are some of the top benefits of LISS training:

Improves Cardiovascular Health:

LISS training is excellent for improving cardiovascular health. It strengthens the heart and lungs, improves blood flow, and enhances overall cardiovascular function. LISS training can also lower blood pressure and cholesterol levels, reducing the risk of heart disease and stroke.

Burns Calories and Fat:

LISS training can be an effective way to burn fat and lose weight. By exercising at a steady pace for an extended period of time, the body burns fat for fuel, which can lead to weight loss and improved body composition. LISS training can also help boost metabolism and improve insulin sensitivity, making it easier to maintain a healthy weight.

Low-Impact and Joint-Friendly:

LISS training is low-impact and joint-friendly, making it an excellent option for people with joint pain or injuries. By using low-impact exercises such as walking or cycling, LISS training allows you to get the benefits of cardio without putting stress on your joints.

Can be Done Anywhere:

LISS training is a versatile form of cardio that can be done almost anywhere, with little to no equipment required. Whether you’re walking outside, cycling on a stationary bike, or swimming laps in a pool, you can do LISS training almost anywhere, making it an excellent option for people who travel frequently or who prefer to exercise at home.

Relieves Stress and Improves Mood:

LISS training can help relieve stress and improve mood. By increasing blood flow and oxygen to the brain, LISS training can boost mood, reduce anxiety and depression, and improve overall mental health. It can also help you sleep better, leading to more energy and better overall health.

Here are some recommendations for frequency, intensity, and duration for LISS training:

Frequency: Aim to do LISS training 3-5 times per week.

Intensity: LISS training should be performed at a moderate intensity, with a heart rate between 60-70% of your maximum heart rate. To calculate your maximum heart rate, subtract your age from 220.

Duration: Aim to do LISS training for 30-60 minutes per session.

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