Anterior cruciate ligament reconstruction & accelerated rehabilitation: hamstring tendons, remodelling and osteorarthritis

The knee owes its stability to the sophisticated combined action of tendons and ligaments. Problems in this mechanism are not uncommon, especially on the sports fields. A ‘plop’ sound while having one’s knee giving way is typical of an anterior cruciate ligament tear, a common knee injury. Women suffer cruciate ligament injuries up to eight times more often than men.
In the Netherlands, more than 8,000 cruciate ligament procedures are carried out each year. The prospects for recovery are good provided that the other parts of the knee have not been damaged. Hamstring tendons regenerate after having been removed during this procedure. It is ill-advised to resume unrestricted sporting activities four to six months after surgery. The findings of this dissertation have resulted in adjustments to rehabilitation protocols for (elite) athletes all over the world. Ten years after the operation, more than fifty per cent of all athletes are shown to have arthrosis. Due to the emergence of women’s football and an increase in the number of cruciate ligament injuries mostly in young people, the number of athletes with knee arthrosis is expected to increase in the future.