Changes in atrophy-inducing cytokines levels, knee strength found after ACL reconstruction

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"/> 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href="https://web.archive.org/web/20130622110614/http://www.healio.com/orthopedics/sports-medicine/news/online/%7B6c1f1c04-8ad0-4d22-bf4d-b58ef21bcacf%7D/study-consider-rehabilitation-over-immediate-acl-reconstruction-for-young-active-adults">Study: Consider rehabilitation over immediate ACL ...</a></li><li><a href="https://web.archive.org/web/20130622110614/http://www.healio.com/orthopedics/sports-medicine/news/online/%7Bdc838691-51aa-4ffb-8407-509bda351afb%7D/early-open-kinetic-chain-exercises-improve-quadriceps-strength-after-acl-reconstruction">Early open kinetic chain exercises improve quadriceps ...</a></li><li><a href="https://web.archive.org/web/20130622110614/http://www.healio.com/orthopedics/sports-medicine/news/online/%7Bdb19986b-de7d-4c84-9a83-06907d747b66%7D/race-age-socioeconomic-status-predict-risk-of-acl-reconstruction-after-injury-">Race, age, socioeconomic status predict risk of ACL ...</a></li></ul></div>  <div class="content"> <h2> Changes in atrophy-inducing cytokines levels, knee strength found after ACL reconstruction</h2> <h3 class="deck"> </h3> <p class="main-subtitle"> </p> <ul class="meta-info"> <li> June 18, 2013</li> </ul> <div class="wyContent"> <p class="BodyCxSpFirst">Following ACL reconstruction, researchers observed an increase in the levels of proatrophy, proinflammatory and cartilage turnover cytokines and biomarkers as well as corresponding changes in knee strength and functional scores, according to a recently published study.</p> <p class="BodyCxSpMiddle">“We’ve had several advances in technology to improve the recovery process for an ACL tear, but most patients still experience 30% to 40% muscle weakness — and that weakness largely limits the ability to return to the same level of sports,” <b>Christopher L. Mendias, PhD, ATC,</b> assistant professor of Orthopaedic Surgery and Molecular & Integrative Physiology at the University of Michigan Medical School, stated in a press release. “This is the first study in humans to open the door to a potential therapy to prevent muscle atrophy. We see this as an important step in restoring athletic and functional abilities in the short term, and in preventing osteoarthritis in the long term.”</p> <p class="BodyCxSpMiddle">In the study, 18 patients underwent surgical reconstruction of the ACL after a noncontact athletic injury. At the preoperative and six postoperative visits, researchers measured the circulating levels of biomarkers along with SF-12, International Knee Documentation Committee and objective knee strength measures. Researchers also tested differences using repeated-measures one-way analysis of variance.</p> <p class="BodyCxSpMiddle">The researchers found myostatin, TGF-beta and C-reactive protein levels significantly increased in the early postoperative period and then returned to baseline. Similarly, cartilage oligomeric matrix protein levels decreased immediately after surgery before returning to baseline.</p> <p class="BodyCxSpMiddle">“Although further studies are necessary, the therapeutic inhibition of myostatin may help prevent the muscle atrophy that occurs after ACL reconstruction and provide an accelerated return of patients to sport,” the researchers wrote in the abstract.</p> <p class="BodyCxSpMiddle"><b>Reference:</b></p> <p class="BodyCxSpMiddle">Mendias CL. <i>Am J Sports Med</i>. 2013;doi:<a href="https://web.archive.org/web/20130622110614/http://ajs.sagepub.com/content/early/2013/06/05/0363546513490651.abstract" target="_blank">10.1177/0363546513490651</a>.</p> <p class="BodyCxSpLast" style="margin: 0in 0in 10pt;"><b>Disclosure: </b>Mendias has no relevant financial disclosures.</p> </div>  <div class="fig left"> <p class="figcaption"> </p> </div> <div class="wyPagination">   </div>  <div class="follow"> <img src="/web/20130622110614im_/http://www.healio.com/~/media/Images/News/FollowUs.jpg" id="layout_0_maincontent_1_SocialFollow_socialfollow" name="socialfollow" alt="Follow us" usemap="#followus" border="0"/> <map id="followus" name="followus"> <area id="layout_0_maincontent_1_SocialFollow_followfb" shape="rect" coords="51,5,5,51" target="_blank" href="https://web.archive.org/web/20130622110614/https://www.facebook.com/OrthopedicsToday" alt="Follow us on Facebook"></area> <area id="layout_0_maincontent_1_SocialFollow_followtw" shape="rect" coords="241,3,281,50" target="_blank" href="https://web.archive.org/web/20130622110614/https://twitter.com/orthotoday" alt="Follow us on Twitter"></area> </map> </div> </div>  <div class="social-links"> <div class="fb-like" data-send="false" data-width="300" data-show-faces="true" data-action="recommend"></div> <ul class="share"> <li><a href="javascript:void(0)" id="twitter" target="_new">Tweet</a></li> <li><a href="javascript:void(0)" id="facebook" target="_new">Share</a></li> <li class="linkedin"><a href="javascript:void(0)" id="linkedin">Link</a></li> <li><span class="db-wrapper"><span class="g-plusone" data-size="tall" data-annotation="none"></span></span></li> <li><a href="javascript:void(0)" id="email">Email</a></li> <li class="last"><a href="javascript:void(0)" id="print">Print</a></li> </ul> </div>  <div id="respond"> <h4> Comments</h4> <script language="javascript" type="text/javascript"> var idcomments_acct = 'aa6ff53f9870e40f92f83e1b5df3cddf'; var idcomments_post_id = '{9EE875F3-5104-4712-9F65-9AEC18109626}'; var idcomments_post_url; </script> <span id="IDCommentsPostTitle" style="display: none"></span> <script type="text/javascript" src="https://web.archive.org/web/20130622110614js_/http://www.intensedebate.com/js/genericCommentWrapperV2.js"></script> <p class="comment-notes"> Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. 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