QUALIFICATION OF SAFE RETURN TO PLAY CRITERIA AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Year 2018, Volume: 25 Issue: 1, 7 - 18, 01.03.2018

Sabriye Ercan , Hilmi Mustafa Demir Yurdagül Baygül Atalay Ozan Turgay Tolga Atay Cem Çetin

https://doi.org/10.17343/sdutfd.290419

Cited By: 1

Abstract

Anterior
cruciate ligament (ACL) plays an important role in maintaining the function of
the knee. In case of injury declining of the muscle strength and unstability of
the knee occurs which affects the thigh muscle functions in a bad way.
Conservative or/and surgical methods are used as a treatment method. In
literature, different criterias can be found for return to play. Even though
these criterias were fulfilled, in two years time after first ACL
reconstruction, rerupture of the ACL risk is high.

Purpose
of this study is, compare ACL recontructed patients’ data, who have normal knee
functions according to return to play guideline, to their health extremity and
to non-injuered healthy subjects’ data.

14
healthy male subject and 15 unilaterally ACL reconstructed patient enrolled
into the study. Tegner activity scale, Lysholm Knee Score and active range of
motions were evaluated. Single leg hop test, flamingo balance test, isokinetic
test and proprioceptive evaluations were done too.

There
were no statistically significant differecences demographical datas, activity
levels and knee scores between groups (p>0,05). Passive joint sense at 30˚
has statistically significant difference between operated and healthy knee
(p<0,05, operated knee has better result). Between ACL group patients and
healthy subjects, there were statictically significant differences between
functional tests, proprioseptive measurements and operated extremity hasmtring
muscle strength (p<0,05).

Arthrogenic
muscle inhibition occurs bilaterelly after an unilateral ACL rupture. This
event causes a misguiding for gaining a functional symmetrical extremities.
However knee functions can be insuffienct in contrast to healthy subjects. For
this reason at ACL rehabilitation programme, improving lower extremity
functions should be done bilaterally.

Keywords

Anterior Cruciate Ligament, sportive rehabilitation, return to play guideline

ÖN ÇAPRAZ BAĞ REKONSTRÜKSİYONU SONRASI SPORA GÜVENLİ GERİ DÖNÜŞ KRİTERLERİNİN YETERLİLİĞİ

Abstract

Ön
çapraz bağ (ÖÇB) yaralanması, kas kuvvetinin azalmasına ve instabilite
gelişmesine bağlı olarak uyluk kaslarının fonksiyonunu olumsuz yönde etkiler.
Tedavide konservatif ve/veya cerrahi yöntemler tercih edilir. Literatürde spora
geri dönüş için farklı kriterler önerilmiştir. Her ne kadar bu kriterler
sağlanmış olsa da ÖÇB rekonstrüksiyon sonrası ilk iki yılda rerüptür riski
yüksektir.

Bu
çalışmanın amacı; ÖÇB rekonstrüksiyonu sonrası normal diz fonksiyonlarına
dönenlerin opere taraflarına ait fonksiyonel diz verilerinin incelenmesi, bu
verilerin sağlam taraf ve sağlıklı kontrol grubu verileri ile
karşılaştırılmasıdır.

14
sağlıklı erkek ile unilateral ÖÇB rekonstrüksiyonu geçiren 15 erkek hasta
çalışmaya katıldı. Çalışmamızda Tegner aktivite seviyesini, Lysholm diz puanını
ve aktif eklem hareket açıklığını ölçtük; tek bacak hoplama testini, flamingo
denge testini, izokinetik kas kuvveti ve propriosepsiyon testini uyguladık.

Gruplar
arasında demografik veriler, aktivite düzeyi ve diz skorları açısından istatistiksel
anlamlı farklılık yoktu (p>0,05). 30˚’deki pasif eklem pozisyon duyusu
testinde opere ve sağlam diz arasında opere diz lehine istatistiksel anlamlı
farklılık tespit edildi (p<0,05). ÖÇB yaralanması geçiren hastalar ve
kontrol grubu arasında fonksiyonel testlerde, propriosepsiyon ölçümlerinde ve
opere ekstremitenin hamstring kas kuvvetinde istatistiksel anlamlı farklılık
saptandı (p<0,05).

Unilateral
ÖÇB rüptürü sonrası artrojenik kas inhibisyonu bilateral gelişir. Bu durum,
ekstremite simetrisinin sağlandığı yönünde yanıltıcı yorumlara yol açabilir.
Halbuki diz fonksiyonları sağlıklı kontrol grubu ile kıyaslandığında yetersiz
olabilir. Bu sebeple, ÖÇB rehabilitasyon programında bilateral alt ekstremite
fonksiyonlarını geliştirmeye önem vermeliyiz.

Keywords

Ön çapraz bağ, sportif rehabilitasyon, spora geri dönüş kriterleri

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