gms | German Medical Science

Objective: The delay, deliberately or not, of the surgery in anterior cruciate ligament reconstruction determines a supplementary diminution of the muscular strength, of the mobility and generally, of the knee functionality contributing to the complication of the post operative rehabilitation progress. The study is aiming to demonstrate the concrete highlighting of the efficiency of applying a pre-operative physiotherapy program in late plastic surgeries of anterior cruciate ligament.

Material/Methods: We conducted a prospective study on 24 patients all performance athlete (mean age 23.3±3.1 years) who, subsequent to sport related injuries, were diagnosed (clinically, arthroscopic and/or visually – by M.R.I.) with partial or total anterior cruciate ligament rupture and were submitted to, within a period of 3–6 weeks after the injury, to a surgical intervention involving ligamentoplasty through the usage of an autogenous patellar tendon graft. The objectives of the specific preoperative kinetic program: controlling the inflammatory process: edema and pain management, restore range of motion, improve flexibility, increase strength, promote gait/walking, and increase function. Patients were divided in two groups of 12 patients: the study group benefited a specific preoperative kinetic program, while the witness group, out of various reasons (fear of pain, of the possible negative reactions upon the injured knee, mental state inappropriate), was not subjected to such a program. All patients were evaluated at the inclusion and after 7 months with a universal goniometer for the range of motion (knee flexion) and manual muscle testing (quadriceps femoris muscle, hamstrings muscle, and triceps surae muscle). To compare the data at baseline and at the end of the study we used the paired t test.

Results: Results are presented as mean±standard deviation. The evaluation of the athletes included in study group at the end showed an statistically significant increase in recovery of full range of motion (42,5±4,52 to 138,6±3,58 p=0.003) compared with the witness group. The results of the manual muscle testing also showed statistically significant increase in muscle strength for the study group: for quadriceps femoris muscle (2,41±0,51 to 5±0, p=0.0001), hamstrings muscle (2,40 ±0,51 to 5±0,50, p=0.0001), triceps surae muscle (2,33±0,49 to 5±0, p=0.0006).

Conclusion: The results of our study show the efficiency of applying a preoperative physiotherapy program to the athletes included in study group compared with the witness group athletes.The necessary time to go back into specific activity, which is based on subjective and objective criteria concerning the rehabilitation of the injured knee, as well as the usefulness of employing this type of recovery program for this type of surgery and for other orthopedic interventions (meniscus repair, meniscectomy).Physical therapy performed following surgery can help decrease the amount of time required to recovery for the athlete and promote the total functional gain and to return in the sport activity at the high level of physical performance.The athletes were able also to return to the sport quickly compared with the athletes included in witness group.