Anterior Cruciate Ligament Rupture, Muscle Weakness
Conditions
Brief summary
Anterior cruciate ligament (ACL) injury is a common sport injury in both professional and recreational athletes. Furthermore, persistent quadriceps weakness and wasting are frequently observed after anterior cruciate ligament reconstruction (ACLR). Several studies have demonstrated that muscular rehabilitation to normal strength is difficult, protracted, and often not achieved due to the inability to fully activate the quadriceps voluntarily. Pain and disuse are often blamed for the inhibition of muscle activation following joint injury. However, arthrogenic muscle inhibition (AMI) is often overlooked and not addressed. Thus, the magnitude of strength restoration of the quadriceps is frequently restricted despite solid rehabilitation protocols. As AMI is a reflex inhibition of musculature involving the neurotransmitter γ-aminobutyrate (GABA), Gabapentin may have a potential role in modulating AMI, therefore limiting muscle weakness after ACLR.
Interventions
DRUGGabapentin
Gabapentin 300mg daily
DRUGTramadol
Tramadol 50mg QID
DRUGPanadol
Panadol 500mg QID
Sponsors
Hospital Authority, Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
1. Age 18-50 2. Unilateral isolated ACL tear for primary ACLR confirmed clinically and radiologically 3. No concomitant ligamentous, meniscal or chondral injuries.
Exclusion criteria
1. Concomitant multiple ligament injuries including posterior cruciate ligament, medial collateral ligament ligament, or lateral collateral ligament 2. Concomitant meniscal injuries 3. Concomitant chondral injuries 4. preoperative radiographic signs of arthritis 5. Revision ACL surgery 6. Contralateral knee with 7. Medical co-morbidities including Diabetes Mellitus, chronic renal failure 8. Documented hypersensitivity to Gabapentin 9. History of epilepsy 10. History of depression 11. Non-compliance to rehabilitation protocol.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in from baseline quadriceps muscle strength | at postoperative 4, 6, 9, 12 months | Will be measured using Biodex isodex dynamometer to measure peak torque of knee extension |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anterior-posterior knee stability | at postoperative 4, 6, 9, 12 months | Measured by Lachman test |
| Rotational laxity | at postoperative 4, 6, 9, 12 months | Measured using the pivot shift test according to the IKDC score |
| Functional outcome | at postoperative 4, 6, 9, 12 months | Measured using single leg hop test |
Contacts
Primary ContactJonathan P Ng, MBBCh MRCS
Outcome results
None listed