Tag: więzadło krzyżowe przednie

The usefulness of kinesitherapy in the process of rehabilitation following surgical reconstruction of the anterior cruciate ligament: a comparative analysis of exercise methods in open and closed kinematic chains

Wojciech Hagner

Wojciech Hagner – The usefulness of kinesitherapy in the process of rehabilitation following surgical reconstruction of the anterior cruciate ligament: a comparative analysis of exercise methods in open and closed kinematic chains. Fizjoterapia Polska 2003; 3(1); 1-7

Abstract
Background. Damage to the ligamental and capsular apparatus of the knee, especially the anterior cruciate ligament (ACL), leads to instability of the knee, manifesting functionally as unsatisfactory joint coordination and slippage of the plateau of the tibia. The choice of treatment should be dictated by the extent of damage incurred by the knee and the patient’s age and degree of physical activity. Surgical reconstruction of the ACL restores joint coordination, but the final outcome is largely determined by post-surgical kinesitherapy. In planning the rehabilitation program after surgical reconstruction of the ACL, it is necessary to bear in mind the impact exercises will have on knee stability, as well as on the work and load of the passive and dynamic stabilizers of the knee.Material and methods. In this article the effects of exercises in systems based on open and closed kinematic chains are subjected to statistical analysis, as well as the impact of such exercises on the relative movements of the individual structural elements of the knee.Conclusions. The results of the present study showed that kinesitherapy in open and closed kinematic chains has a positive impact on rehabilitation outcome after ACL reconstruction, while the decisive factor is the skillful combination of exercises from both types of kinematic chain.

Key words:
Anterior Cruciate Ligament, kinesitherapy, open kinematic chain, closed kinematic chain

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The role of passive stiffness of the hamstring muscies in body stability processes

Michał Kuszewski, Edward Saulicz, Andrzej Myśliwiec, Tomasz Wolny

Michał Kuszewski, Edward Saulicz, Andrzej Myśliwiec, Tomasz Wolny – The role of passive stiffness of the hamstring muscies in body stability processes. Fizjoterapia Polska 2009; 9(3); 195-201

Abstract
Two closely interrelated concepts of the biokinematic link have emerged in recent years. One of them divides human muscies functionally into stabilizing and motor ones, while the other concept describes three closely cooperating subsystems which, in a normal individual, function to secure an adeąuate level of stabilization. Each ofthese concepts can be linked with the notion of passive muscle stiffness. However, the majority of publications concerning stabilization processes seems to attach little importance to this property This paper introduces the concepts of development and role of increased passive stiffness of the hamstring muscies in the stabilization process. Basing on neurophysiological mechanisms, the authors present the latest research results, the mechanisms behind increased passive stiffness and ways of reducing it.
Key words:
stability, muscle stiffness, ACL, LPH complex
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Assessment of the effectiveness of selected physical therapy procedures in the early post-operative period fol łowing ACL surgery. Pilot study

Anna Polak, Ewa Grymel-Kulesza, Janusz Kubacki, Piotr Król

Anna Polak, Ewa Grymel-Kulesza, Janusz Kubacki, Piotr Król – Assessment of the effectiveness of selected physical therapy procedures in the early post-operative period fol łowing ACL surgery. Pilot study. Fizjoterapia Polska 2010; 10(1); 12-24

Abstract
Background. The study aimed to assess the effectiveness ofa therapeutic regimen combining kinesiotherapy, cryotherapy and electrical stimulation in patients with a surgically treated anterior cruciate ligament (ACL). Materials and methods. Twenty-four patients with reconstructed ACL participated in the study. The patients were randomly divided into Groups A and B, each group containing 12 indMduals. Both groups received kinesiotherapy and cryotherapy according to the same programme, but Group B additionally received electrical stimulation. A therapeutic cycle comprised kinesiotherapy, cryotherapy and electrical stimulation procedures, ten of each kind. Sessions took place three times a week. The progress of healing in the patients was followed by assessing passive and active flexion at the knee, measuring the knee-joint circumference and load-testing of the limb.Results. After the treatment, both groups showed statistically significant improvements in flexion of the knee joint and reduced swelling of the joint. The leg-loading test performed after the treatment provided statistically significant improvement compared to pre-treatment data in both groups. No statistically significant differences were found between the two groups regarding treatment effectiveness.Conclusions. A combination of kinesiotherapy and cryotherapy is an effective adjunct to the treatment of patients with a surgically treated anterior cruciate ligament. The introduction of electrical stimulation did not offer additional therapeutic benefits.
Słowa kluczowe
anterior cruciate ligament, ACL, kinesiotherapy, cryotherapy, electrical stimulation
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Sensibility disorders after ACL reconstruction with BTB graft

Dariusz Grela, Anna Morawik

Dariusz Grela, Anna Morawik – Sensibility disorders after ACL reconstruction with BTB graft. Fizjoterapia Polska 2010; 10(4); 299-306

Abstract
Background. The purpose of the research was to analyse data concerning superficial sensibility disorders on the lateral side of knee joint occurring after reconstruction of anterior cruciate ligament (ACL) with bone-tendon-bone (BTB) graft.
The research was mainly to find out the span of time after which ailments of this type subsided.
Material and methods. The research was carried out among 137 patients who underwent ACL reconstruction with BTB. They were asked to fill in question naires after 3, 4, 5, 6, 12, 18 and 24 months after the surgery. Questions were to find out information about the region of sensibility disorders, current quality of the disorders and the time span after which the disorders sustained.
Results. Patients after anterior cruciate ligament reconstruction with a graft taken from patellar tendon report sensibility disorders on the lateral side of the knee joint below the patella on the level of the scar. Most often these ailments subside after 12-18 months after the surgery. Superficial sensibility was back after 4 months at the earliest.
Conclusions. In case of most patients, superficial sensibility in the discussed region was fully restored. This allows to state that the examined disorders are temporary. Before a patient regains normal sensibility, many procedures in physiotherapy of the region we are discussing should be applied very carefully.
Key words:
sensation disorders, nerve regeneration, anterior cruciate ligament
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Evaluation of pre and post operative physiotherapy using the Lysholm scale on functional Outcomes in Patients undergoing Anterior Cruciate Ligament Reconstruction

Sebastian Zduński, Witold Rongies

S. Zduński, W. Rongies – Evaluation of pre and post operative physiotherapy using the Lysholm scale on functional Outcomes in Patients undergoing Anterior Cruciate Ligament Reconstruction. Fizjoterapia Polska 2020; 20(1); 130-143

Abstract
Background. Most anterior cruciate ligament (ACL) injuries require surgery and physiotherapy. One important factor that determines physiotherapeutic success is achieving optimal function already before an ACL reconstruction surgery.
Material and methods. A total of 72 randomly enrolled patients, who had been diagnosed with a complete ACL tear and qualified for surgical reconstruction, were included in this study. The experimental group comprised 37 patients aged from 18 to 60 years (mean age 37 ± 10.3 years). All patients from this group underwent a physiotherapy regimen based on established rehabilitation practices over a period of 4 weeks preceding the surgery. The control group comprised 35 patients aged from 18 to 60 years (mean age 34 ± 10.0 years) who did not undergo any preoperative physiotherapy regimen.
Results. At the second time point, both the experimental and control groups exhibited significant improvement in Lysholm scores in comparison with baseline scores (p < 0.05). The Lysholm-Gillquist score in the experimental group was better in the experimental group. There was a significant difference in Lysholm functional knee scores in experimental and control subjects at postsurgical week 6 and 12 (p < 0.05).
Conclusions. 1. Physiotherapy in patients with a complete ACL tear is an important and beneficial factor improving knee function prior to ACL reconstruction.
2. Functional knee scores (assessed with the Lysholm scale) obtained in both groups after the reconstruction surgery confirmed the effectiveness of surgical procedures and physiotherapeutic protocols.

Key words:
knee joint, anterior cruciate ligament, Lysholm-Gillquist scale

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Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire

Sebastian Zduński, Witold Rongies, Marcin Ziółkowski, Tomasz Kozieł, Janusz Sierdziński

S. Zduński, W. Rongies, M. Ziółkowski, T. Kozieł, J. Sierdziński – Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire. FP 2017; 17(2); 60-70

Abstract

Introduction. In recent years, there has been an increase in the number of knee injuries with subsequent total anteriur ligament injury (ACL). ACL lesions in most cases require specialized surgical and physiotherapeutic treatment. The main goal of rehabilitation is to restore the full function of the knee joint and the entire lower limb. Interest in methods of assessing the outcome of ACL reconstruction procedures has increased recently. A number of questionnaires and scales were developed to assess the outcome of treatment. An example is the Knee and Osteoarthrosis Outcome Score (KOOS).
The aim of the study. Assessment of near and distant outcomes of post-arthroscopic anterior cruciate ligament reconstruction in the selected model of Knee and Osteoarthrosis Outcome Score (KOOS).
Material and methodology. Randomized study included 72 patients with a complete rupture of the ACL identified for operative reconstruction. The study group included 37 patients aged 18 to 60 years (mean 37 ±10.3 years). All subjects in this group were subjected to a physiotherapy for 4 weeks prior to reconstructive surgery. In total, 10 to 12 therapeutic sessions were conducted. The control group included 35 patients aged 18 to 60 years (mean 34 ±10.0 years) who did not perform the preoperative physiotherapy program. The postoperative physiotherapy program was the same in all subjects studied.
Results. There was a statistically significant improvement in the functional assessment of the knee joint after reconstruction of the ACL using the KOOS questionnaire in the Study and Control groups at subsequent measurement points (p < 0.05). Better results in the Study Group were found in almost all subgroups of KOOS (symptoms, stiffness, daily activities, activity, quality of life) 6 and 12 weeks after ACL reconstruction. However, there was no statistically significant difference between the Study and Controlled Group (p > 0.05). There was a statistically significant difference in the “stiffness” of the KOOS scale after 12 weeks (p < 0.05). There was also a statistically significant difference in the SP3 (skipping ability) of the KOOS scale after 12 weeks (p < 0.05).
Conclusions. 1. Obtained results in both examined groups, in terms of functional capabilities evaluated by the KOOS questionnaire after reconstruction, confirm the good quality of performed surgical procedures and physiotherapeutic activities.  2. A better KOOS score in the Study Group indicates the high therapeutic value of preoperative rehabilitation.

Key words:
anteriur cruciate ligament, knee joint, physiotherapy, KOOS questionnaire

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Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes

Patrycja Szkutnik, Marcin Domżalski

P. Szkutnik, M. Domżalski: Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes. FP 2015;15(4);74-81

Abstract

Traumas of the anterior cruciate ligament (ACL) are the most common injuries of a knee joint in athletes. We diagnose them by specific clinical tests – Lachman test, anterior drawer test, pivot-shift test and additional imaging studies. Form of the treatment is to reconstruct the ligament with a graft taken muscle. After treatment, there is still a problem with the rotational instability. Only 60% of the athletes returned to pre-injury form. This is due to anterolateral ligament (ALL) of knee. It is a ligament that occurs in approximately 95% of the population. It’s located on the anterolateral side of the knee joint which connects the femur with the tibia bone, it is responsible for rotational stability of the knee, especially when bent knee (30-90 deg) and it`s supports the function of the ACL. ALL trauma that may be asymptomatic, they can imply subsequently breaking of the ACL. However, when ACL is ruptured, almost always the ALL is damaged too. Ruptures and damages of ALL have a connection with Segond fractures. Undetected damage of ALL causes treatment failure of the anterior cruciate ligament injuries. It should be taken into consideration that with concomitant ACL and ALL injuries conservative treatment of damaged ALL is enough for treatment and rehabilitation success or if reconstruction of the ALL also necessary. The aim of the study is to highlight the widespread problem of knee injuries in athletes and how they should be treated so it will lead to full recovery of the competitor and his/her faster return to the game.

Key words:
knee joint, anterolateral ligament of the knee, anterior cruciate ligament, characteristic, trauma

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