Hardin J A, Voight M L, Blackburn T A, Canner G C, Soffer S R
Berkshire Institute of Orthopedic and Sports Physical Therapy, Wyomissing, PA 19610, USA.
J Orthop Sports Phys Ther. 1997 Jul;26(1):29-34. doi: 10.2519/jospt.1997.26.1.29.
Current concepts in postoperative anterior cruciate ligament (ACL) reconstruction management include participation in an "accelerated" rehabilitation program. There are no published reports examining the effects of accelerated or conservative rehabilitation on subjects with generalized ligamentous hyperelasticity. The purpose of this case study was to examine the effects of a conservative or "decelerated" rehabilitation program on the functional outcome of a hyperelastic female adolescent athlete following ACL reconstruction. The subject was a 15-year-old female basketball player who sustained a unilateral ACL tear and underwent subsequent ACL reconstruction using a patellar tendon autograft. The subject immediately began participation in a "decelerated" rehabilitation program in which the intensity and rate of progression was decelerated, emphasizing a prolonged period of maximum graft protection. Progress was objectively quantified with a battery of diagnosis-specific tests at scheduled intervals. Results at 52 weeks postoperative revealed normal range of motion, proprioception, balance, knee stability, quadriceps strength, hamstring strength, and subjective assessment values, and only a 4.0% deficit in functional scores. Our results suggest a "decelerated" rehabilitation program may be appropriate for the population with generalized ligamentous hyperelasticity by yielding excellent functional results without compromising the integrity of the graft and, ultimately, knee stability.
目前术后前交叉韧带（ACL）重建管理的理念包括参与“加速”康复计划。尚无已发表的报告研究加速或保守康复对具有全身性韧带超弹性的受试者的影响。本病例研究的目的是检验保守或“减速”康复计划对一名超弹性女性青少年运动员ACL重建后功能结局的影响。该受试者是一名15岁的女性篮球运动员，单侧ACL撕裂，随后使用髌腱自体移植物进行了ACL重建。该受试者立即开始参与“减速”康复计划，其中康复强度和进展速度减缓，强调延长对移植物的最大保护期。定期通过一系列特定诊断测试对进展情况进行客观量化。术后52周的结果显示，关节活动范围、本体感觉、平衡、膝关节稳定性、股四头肌力量、腘绳肌力量和主观评估值均正常，功能评分仅存在4.0%的缺陷。我们的结果表明，“减速”康复计划可能适用于具有全身性韧带超弹性的人群，因为它能产生优异的功能结果，同时不损害移植物的完整性以及最终的膝关节稳定性。
