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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article presents the findings of a randomized controlled trial on the effect of femoral nerve block (FNB) on quadriceps muscle strength and patient-reported outcomes following anterior cruciate ligament (ACL) reconstruction.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ERobert A. Magnussen, MD, MPH, Wexner Medical Center, Ohio State University, Columbus, Ohio, USA, presented the findings of a randomized controlled trial on the effect of femoral nerve block (FNB) on quadriceps muscle strength and patient-reported outcomes following anterior cruciate ligament (ACL) reconstruction.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EACL reconstruction (ACLR) in athletes seeks to restore knee stability to withstand abrupt sports-related directional changes and pivoting. Postoperative rehabilitation often involves the restoration of quadriceps muscle strength to permit optimal sports performance and reduce the risk of re-injury. Blocking the function of the femoral nerve perioperatively can be done as a means of pain relief. Whether the approach hampers recovery of the quadriceps muscle is unclear [Atchabahian A et al. \u003Cem\u003EAnesthesiology\u003C\/em\u003E 2001].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe trial addressed the hypotheses that perioperative FNB would result in significantly diminished strength in the lower quadriceps muscle 6 weeks after ACLR, as compared with preoperative muscle strength, and that postoperative improvements reported by patients would be delayed when FNB was used perioperatively.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThirty patients who had experienced acute ACL injury and whose ACLR involved a hamstring autograft were randomly assigned to a group receiving a single injection of 20 mL of .5% ropivacaine using ultrasound guidance (n = 14) or a control group (n = 16) not receiving the FNB. Both groups underwent standard accelerated rehabilitation with weight bearing as tolerated and no braces. All patients were assessed preoperatively and at 12 weeks postoperatively using the patient-reported Knee Injury and Osteoarthritis Outcome Score (KOOS), and isokinetic strength was tested at 60\u00b0 per second. A 6-week postoperative assessment for all patients included KOOS and isometric strength testing at 90\u00b0 of flexion.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EPatients in both groups were similar preoperatively in age, gender composition, height, weight, body mass index, limb symmetry, and patient-assessed activities of daily living (ADLs), pain, and symptoms (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14774\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14774\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14774\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EPreoperative Characteristics in Patient Groups\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003ENo surgical or nerve block complications were evident, and clinically detectable femoral nerve palsy was absent in all patients throughout the follow-up period. Comparisons prior to ACLR and 6 weeks after surgery revealed that quadriceps strength did not vary significantly between the left and right legs in the absence of FNB, whereas nerve block was associated with significantly decreased quadriceps strength in the operative leg 6 weeks postoperatively (p \u0026lt; .05). By 12 weeks, quadriceps strength in both legs was similar in both patient groups.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EDr. Magnussen then addressed the association between FNB and KOOS values of ADL, pain, and symptoms. Both groups improved during the 12-week follow-up. The improvement was, however, more pronounced at 6 weeks in the absence of FNB. The change in KOOS ADL score at 6 weeks in the absence of block (6.5 \u00b1 9.1) was greater than in the presence of block (.1 \u00b1 11.3), but it was not significantly different (p = .12). Changes in KOOS pain and symptom values at 6 weeks postoperatively with no block (7.5 \u00b1 9.0 and 10.1 \u00b1 12.4, respectively) and with block (\u22121.1 \u00b1 14.1 and \u22123.0 \u00b1 21.3, respectively) were not significant (p = .069 and p = .059). Values of all assessed parameters at 12 weeks postoperatively were similar between groups.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EFNB was associated with decreased quadriceps strength and an absence of patient-reported improvements at 6 weeks postoperatively. By 12 weeks, these deficits were not apparent. The long-term effects, if any, of quadriceps weakness in the early weeks following ACLR in patients receiving perioperative FNB remain unclear.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/23\/22.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzoxa1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzoxa1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}