Ön Çapraz Bağ Rekonstrüksiyonu Sonrası Operasyonun Fonksiyonel Sonuçlarının Sportif Aktivitelerle İlişkisi

Year 2021, , 188 - 192, 29.05.2021

Ferdi Sarı , Murat Özşahin , Nezih Ziroğlu

https://doi.org/10.29058/mjwbs.855676

Abstract

Amaç: Bu çalışmada, amatör olarak spor yapan ve ön çapraz bağ (ÖÇB) rekonstruksiyonu yapılan bireylerde, operasyonun fonksiyonel sonuçları ve sportif aktiviteleriyle olan ilişkisinin araştırılması amaçlandı.
Gereç ve Yöntem: Ön çapraz rüptürü nedeniyle dört katlı hamstring otogrefti ile artroskopik rekonstrüksiyon uygulanan hastaların fonksiyonel sonuçlarını Lysolm ve Tegner aktivite skorlama sistemi ile retrospektif olarak anali ettik. Kinezyofobi değerlendirilmesi Tampa ölçeği kullanarak yapıldı.
Bulgular: Çalışmaya dahil olan 61 kişinin tamamı erkekti (yaş dağılım: 17 - 48 yıl, ortalama: 30.6±6.9). Takip süresi en kısa 27 ay iken en uzunu 74 ay olmak üzere ortalama 47,4 ay idi. Ameliyat öncesi ortalama 59,1 (dağılın: 5 - 90) olan Lysholm skoru son kontrolde 95,9’du (dağılın: 69 - 100). Tegner aktivite skorları ortalaması travma öncesi 6,4 (dağılın: 3 - 10), ameliyat sonrası 5,2 (dağılın: 3-10) idi. Tampa kinezyofobi ölçeği 41.2 (29-49) bulundu.
Sonuç: Cerrahi sonucunda, hastaların çoğunda fonksiyonel sonuçlar tatmin edici olarak tespit edilirken, yaklaşık yarısında ise aktivite skorları istenilen düzeye ulaşmıştı. Tampa kinezyofobi ölçeği yüksek bulunması, ÖÇB cerrahisinde ne kadar titiz davranılsa da ameliyat önce ve sonrasında alacağı profesyonel fizyoterapi ve psikolojik danışmanlığın da önemli derecede etkili olabileceğini gösterdi.

Keywords

Ön Çapraz Bağ, Rekonstrüksiyon, Sportif Aktivite

The Relationship Between Functional Results of Operations After Anterior Cruciate Ligament Reconstruction and Sports Activities

Abstract

Objective: In this study, it was aimed to investigate the functional results of the operation and its relationship with sportive activities in individuals who do sports amateur and undergo anterior cruciate ligament (ACL) reconstruction.
Materials and Methods: We retrospectively analyzed the functional results of patients who underwent arthroscopic reconstruction with a four-layer hamstring autograft due to ACL rupture using the Lysolm and Tegner activity scoring system. Kinesiophobia was evaluated using the Tampa scale.
Results: All 61 individuals included in the study were male (age range: 17 to 48 years, mean: 30.6±6.9). The duration of follow-up was 47.4 months, with the shortest 27 months and the longest 74 months. The Lysholm score, which was 59.1 on average before the surgery (range: 5 to 90), was 95.9 at the last control (range: 69 to 100). Tegner activity scores averaged pre-trauma 6.4 (range: 3 to 10), postoperative 5.2 (range: 3 to 10). Tampa kinesophobia scale was found to be 41.2 (range: 29 to 49).
Conclusion: As a result of ACL surgery, functional results were found to be satisfactory in most of the patients, while activity scores reached the desired level in approximately half. On the other hand, the Tampa kinesophobia scale was found to be high. Therefore, it can be considered that professional physiotherapy and psychological counseling that patients will receive before and after the operation can be significantly effective, even if the ACL surgery is meticulously.

Keywords

Anterior Cruciate Ligament, Reconstruction, Sports Activities

References

• Fithian DC, Paxton EW, Stone ML, Luetzow WF, Csintalan RP, Phelan D, et al. Prospective trial of a treatment algorithm for the management of the anterior cruciate ligament-injured knee. Am J Sports Med 2005; 33: 335-346
• Rae PJ, Paterson RS. The natural history of meniscal tears in anterior cruciate ligament insufficiency. Am J Sports Med 1993; 21: 672-679
• Yuksel HY, Erkan S, Uzun M. The evaluation of intraarticular lesions accompanying ACL ruptures in military personnel who elected not to restrict their daily activities: The effect of age and time from injury. Knee Surg Sports Traumatol Arthrosc 2006; 14: 1139-1147
• Keene GC, Bickerstaff D, Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 2004; 50: 3145-3152
• Biswal S, Hastie T, Andriacchi TP, Bergman GA, Dillingham MF, Lang P. Risk factors for progressive cartilage loss in the knee: A longitudinal magnetic resonance imaging study in forty-three patients. Arthritis Rheum 2002; 46: 2884-2892
• Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: A systematic review and meta-analysis of the state of play. Br J Sports Med 2011; 45: 596-606
• Wiger P, Brandsson S, Kartus J, Eriksson BI, Karlsson J. A comparison of results after arthroscopic anterior cruciate ligament reconstruction in female and male competitive athletes. A two- to five-year follow-up of 429 patients. Scand J Med Sci Sports 1999; 9(5): 290-5
• Kori SH, Miller RP, Todd D. Kinesophobia: a new view of chronic pain behaviour. Pain Management 1990; 3: 35-43
• Burwinkle T, Robinson JP, Turk DC. Fear of movement: factor structure of the tampa scale of kinesiophobia in patients with fibromyalgia syndrome. J Painn 2005; 6: 384-391
• Ardern CL, Taylor NF, Feller JA, Webster KE. Return-tosport outcomes at 2 to 7 years after anterior cruciate ligament reconstruction surgery. Am J Sports Med 2012; 40: 41-48.
• Linschoten NJ, Johnson CA. Arthroscopic debridement of knee joint arthritis: Effect of advancing articular degeneration. J South Orthop Assoc 1997; 6: 25-36
• Picavet HS, Vlaeyen JW, Schouten JS. Pain catastrophizing and kinesiophobia: Predictors of chronic low back pain. Am J Epidemiol 2002; 156: 1028-1034
• Çelik D, Coşkunsu D, Kılıçoğlu Ö. Translation and cultural adaptation of the Turkish Lysholm Knee Scale: ease of use, validity and reliability. Clin Orthop Relat Res 2013; 471(8): 2602-10
• Webster KE, Feller JA, Lambros C. Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery. Phys Ther Sport 2008; 9(1): 9–15
• Baltacı G, Yılmaz G, Atay AÖ. The outcomes of anterior cruciate ligament reconstructed and rehabilitated knees versus healthy knees: a functional comparison. Acta Orthop Traumatol Turc 2012; 46(3): 186-95
• Tichonova A , Rimdeikienė İ , Petruševičienė D , Lendraitienė E. The Relationship Between Pain Catastrophizing, Kinesiophobia and Subjective Knee Function During Rehabilitation Following Anterior Cruciate Ligament Reconstruction and Meniscectomy: A Pilot Study. Medicina 2016; 52: 229–237
• Han JK, Chun KC, Lee SI, Kim S, Chun CH. Comparison of Modified Transtibial and Anteromedial Portal Techniques in Anatomic Single-Bundle ACL Reconstruction.Orthopedics 2019; 42(2): 83-89