Abstracts

56 Identifying individuals with an anterior cruciate ligament deficient knee as Copers and Non-Copers:
A narrative literature review
Y. Kaplan 1 *
1
Lerner Sports Center, Hebrew University of Jerusalem, Israel
Introduction: ACL rupture may result in increased tibiofemoral laxity and impaired neuromuscular function, which ultimately may lead to knee
instability and dysfunction. Individuals who opt to choose surgery, due to these changes, may be defined as “non-copers”. Conversely, “copers” may
be defined as individuals with an ACL deficient knee who do not have functional impairment and instability and who successfully resume pre-injury
activity levels without surgical intervention. The aim of this study is to first, explore the differences and outcomes between individuals who have had
anterior cruciate ligament (ACL) reconstruction and those who did not undergo surgical intervention following a tear of the ACL. Second, to review
the evidence related to the ability to identify individuals who may or may not need surgery after an ACL rupture. Finally, to describe the differences
between copers and non-copers.
Methods: An electronic search was conducted up to April 2015, using medical subject headings and free-text words. Subject-specific search was
based on the terms “anterior cruciate ligament reconstruction versus conservative treatment”, “copers”, “non-copers”.
Results: A similar percentage of copers and non-copers return to sporting activity. Three papers used an algorithm and screening examination
involving individuals with ACL injuries. Evidence exists that, as opposed to copers, non-copers have: deficits in quadriceps strength, vastus
lateralis atrophy, quadriceps activation deficits, altered knee movement patterns, reduced knee flexion moment, and greater quadriceps/hamstring
co-contraction.
Discussion: ACL screening examination shows preliminary evidence for detecting potential copers. Objective differences exist between copers and
non-copers. Individuals with ACL injury should be informed of the possibility of good knee function following a non-operative rehabilitation program.
Thursday 22 October
57 Knowledge and beliefs about knee osteoarthritis after ACL injury and reconstruction and acceptability of
prevention strategies
A. Van Ginckel 1 * • K. Bennell 1 • C. O Kean 2 • R. Nelligan 1 • S. French 3 • M. Stokes 4 • M. Batt 5 • D. Hunter 1 • L. Spiers 6 • R. Hinman 1
1
Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne • 2 School of Medical and Applied Sciences, Central
Queensland University • 3 School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University • 4 Faculty of Health Sciences, University of Southampton,
United Kingdom • 5 Nottingham University Hospital, United Kingdom
Introduction: Anterior cruciate ligament (ACL) rupture commonly affects young, physically active individuals. Evidence suggests that, as a result of
such injuries, up to 50% of individuals may develop premature knee osteoarthritis (OA), often when aged in their 30s or 40s. Hence, individuals with
an ACL injury, irrespective of how it is managed, represent a high-risk group for development of knee OA. Health risk knowledge is important to allow
patients to make informed decisions regarding their health and develop behaviors or undergo treatment to change their risk. Furthermore, knowing
patient preferences for potential treatments will provide insight into the feasibility of such treatments. The purpose of this survey was to explore
patients’ knowledge of OA and OA risk following ACL injury and/or reconstruction, extent to which information about these risks and potential
treatments is provided to patients by health professionals, and patients’ treatment preferences.
Methods: A custom-designed survey was conducted in Australian adults who sustained an ACL injury and/or had undergone ACL reconstruction
one to five years prior. The survey comprised four sections: 1) demographics, 2) knowledge about OA and OA risk, 3) advice received from health
professionals about OA risks, and 4) treatment preferences for reducing OA risk. Descriptive statistics were calculated and correlations examined
relationships amongst demographics, risk beliefs and treatment importance.
Results: Complete datasets from 210 eligible respondents were analysed. Most (n=148, 70.4%) rated themselves as being at greater risk of OA
than healthy peers. Most agreed that ACL (n=147, 70.0%) and/or meniscal injuries (n=199, 75.8%) would increase this risk. Fifty-eight (27.6%)
respondents recalled discussion of their OA risk with a health professional. Muscle strengthening and weight loss were most often recommended by
health professionals and preferred by respondents compared to bracing, orthotics, or modified shoes. While female sex, lower body mass index and
higher current physical activity levels positively correlated with beliefs about ACL injury, meniscal tears or meniscectomy as OA risk factors, history
of professional advice positively correlated with these statements and treatment importance ratings.
Discussion: Individuals with a prior ACL injury seem aware of the higher risk of OA. Professional advice appears limited yet vital in improving
patients’ understanding of risks and importance of prevention. While most proposed prevention strategies were deemed acceptable, dedicated
randomised controlled trials are warranted to determine efficacy of such strategies in reducing OA risks in these patients. Future research should
further elucidate how to best educate both clinicians and patients.
58 A systematic review and meta-analysis of knee kinematics and moments after ACL reconstruction:
implications for early-onset knee osteoarthritis
H. Hart 1 2 • A. Culvenor 3 • N. Collins 3 * • D. Ackland 1 • S. Cowan 4 • Z. Machotka 5 • K. Crossley 3
1
Melbourne School of Engineering, The University of Melbourne • 2 Melbourne School of Physiotherapy, The University of Melbourne • 3 School of Health & Rehabilitation
Sciences, The University of Queensland • 4 Physiotherapy Department, St Vincent’s Hospital, Melbourne • 5 International Centre for Allied Health Evidence, University of
South Australia
Background: Biomechanical deficits may drive early degenerative changes in anterior cruciate ligament reconstructed (ACLR) knees. To date,
no comprehensive review of knee biomechanics in ACLR has been conducted. The aim of this study was to conduct a systematic review and
meta-analysis of knee kinematics and moments in ACLR knees during walking.
Methods: Seven electronic databases and reference lists of relevant papers were searched for cross-sectional, human observational studies
comparing knee kinematics and moments during walking in ACLR, with the uninjured contralateral or healthy control knees. Two independent
28 • 2015 ASICS Sports Medicine Australia Conference