REHABILITATION OF PATIENTS WITH IMMATURE SKELETAL SYSTEM AFTER ARTHROSCOPIC RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT - CASE STUDY
Journal Title: Medycyna Sportowa - Year 2013, Vol 29, Issue 3
Abstract
[b]Backround.[/b] Reconstruction of anterior cruciate ligament (ACL) is a common and difficult problem of the contemporary! sport traumatology. This problem concerns not only the elderly population, but mainly young people with immature skeletal systems who have sustained ACL injuries. The most important goal in patients with unfinished bone growth is selection of the surgical technique which could minimize possible damage of the epiphyseal cartilage, combined with directed, individual physiotherapy.[b]Case study.[/b] 15-year old femalepatient sustained ACL injury during a football match. The imaging revealed patella alta, lll-rd degree ACL damage with the stub at the level of the intercondylar eminenn-ce, hindering extension. The patient was subjected to intrastratal, single-bundle ACL reconstruction. During the early postoperative period the management was focused on anti-inflammatory therapy, assurance of optimal healing conditions and graft „securing. During later stages, the range of movement and muscle exercises as well as proprioception improving exercises were applied. During the period o the lowest ACL resistance particular attention was focused on protection of the ligament using rehabilitation, mainly in closed kinematic chains, which was focused on the exercises of knee joint flexor muscles and co-contraction of these muscles. After obtaining a full range of movement as well as mechanical resistance of the graft, physiotherapy was aimed at the increase in muscle strength and control and involved individual sport tratning. The matn goal of the surgical procedure was regaining baseline physical fitness and sport activity level, conditioned by obtaining a full patnless range of movement, stability and muscle strength comparable with those of the uninvolved limb (+/-10%).[b]Conclusions.[/b] Early arthroscopic treatment combined with earty individual rehabilitation for patients with immature skeletal systems after ACL tear is an effective approach, enabling the patient regaining full physical fitness and the return to sport.
Authors and Affiliations
Daniel Demkiewicz, Małgorzata Kulesa-Mrowiecka, Grzegorz Mańko
Keywords
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