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当对侧自体髌腱移植用于初次前交叉韧带重建时双膝的康复计划:病例报告

Rehabilitation program for both knees when the contralateral autogenous patellar tendon graft is used for primary anterior cruciate ligament reconstruction: a case study.

作者信息

De Carlo M, Shelbourne K D, Oneacre K

机构信息

Methodist Sports Medicine Center, Indianapolis, Ind., USA.

出版信息

J Orthop Sports Phys Ther. 1999 Mar;29(3):144-53; discussion 154-9. doi: 10.2519/jospt.1999.29.3.144.

Abstract

STUDY DESIGN

Case study of a basketball player who underwent an alternative surgical procedure for anterior (cruciate ligament (ACL) reconstruction and outline of the rehabilitation process designed for this procedure.

OBJECTIVES

To describe the surgical procedure, detail the rehabilitation program, and report on this patient's clinical outcome.

BACKGROUND

Anterior cruciate ligament injury, its treatment, and rehabilitation continue to be an area of interest to both clinicians and researchers. Surgical procedures have been refined and rehabilitation programs are constantly being evaluated and updated to allow the safest and most predictable return to activity. Currently, the autogenous bone-patellar tendon-bone graft is the graft of choice for ACL reconstruction. Typically the graft is taken from the ipsilateral knee. An alternative procedure is to take the graft from the contralateral, noninvolved knee, allowing 2 separate rehabilitation programs to take place.

METHODS AND MEASURES

The patient was followed from the time of injury to 2 years postoperatively. Data collected included range of motion, isokinetic strength scores, ligament stability scores, subjective evaluation, and functional measures.

RESULTS

At 3 weeks postoperative the patient had nearly full range of motion in both knees, normal gait, and was beginning sport-specific drills. He was shooting the basketball and jumping by 5 weeks and returned to competitive sports 6 weeks after surgery. He was able to play in all 32 games of the season, starting in 23 of them.

CONCLUSIONS

Using the contralateral patellar tendon graft may be appropriate for primary ACL reconstruction of patients, particularly those desiring an early expedient return to athletic competition.

摘要

研究设计

对一名接受前交叉韧带(ACL)重建替代手术的篮球运动员的案例研究以及针对该手术设计的康复过程概述。

目的

描述手术过程,详述康复计划,并报告该患者的临床结果。

背景

前交叉韧带损伤及其治疗和康复一直是临床医生和研究人员感兴趣的领域。手术方法不断完善,康复计划也在持续评估和更新,以实现最安全、最可预测的恢复运动。目前,自体髌腱-骨移植是ACL重建的首选移植物。通常移植物取自同侧膝关节。一种替代方法是从对侧未受伤的膝关节获取移植物,从而可以进行两个独立的康复计划。

方法与措施

对患者从受伤时起至术后2年进行随访。收集的数据包括活动范围、等速肌力评分、韧带稳定性评分、主观评估和功能测量。

结果

术后3周,患者双膝关节活动范围接近正常,步态正常,并开始进行特定运动训练。5周时他能够投篮和跳跃,术后6周恢复竞技运动。他能够参加该赛季的全部32场比赛,其中23场首发。

结论

使用对侧髌腱移植物可能适用于患者的初次ACL重建,尤其是那些希望尽早恢复竞技比赛的患者。

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