Abstract

 The Anterior Cruciate Ligament (ACL) is an important stabilizer of the knee, providing almost 85% of the joint stability to forward force (especially in some aggressive twisting and jumping sports, as skiing and basketball). The common orthopedic surgical intervention is the reconstruction, performed as soon as possible after the traumatic injury. After the orthopedic surgery, a period of rehabilitation must begin and the consultation with a medical doctor - specialist in Physical and Rehabilitation Medicine (PRM) is required. The goal of current article is to suggest a complex PRM-algorithm of care of these patients, based on detailed literature review and on our own clinical practice. In all traumatic knee conditions with a knee surgery, the PRM Algorithm traditionally includes functional evaluation of the knee mobility and stability and a complex PRM programme of care, including natural and preformed physical modalities. The pre-defined PRM protocol includes only physiotherapy (analytic exercises) combined with cryotherapy. Authors consider that the traditions of some rehabilitation schools (e.g. Bulgarian) can be used. We suggest a detailed complex PRM-algorithm, including physiotherapy, cryotherapy, hydro or balneotherapy; and many preformed physical factors: functional electrical stimulations of the quadriceps femoris muscle (accentuating on the heads m.vastus lateralis and m. vastus medialis, especially on m.vastus medialis obliquus); interferential currents; Deep Oscillation; low intensity low frequency magnetic field; ultrasound or ultra-phonophoresis with non-steroidal anti-inflammatory drugs. We propose a practical schema for a patient after ACL reconstruction, through a clinical case presentation: a male patient after reconstruction of the right ACL, after traumatic rupture of the ACL. Immediately after the orthopedic surgery, the patient was treated as inpatient in the PRM Clinic of a Bulgarian University hospital and after - as outpatient in the PRM-Department of an ambulatory Medical Center. We expose the detailed PRM-program and the obtained results in this patient. In conclusion, we emphasize the impact of the complex PRM-programme in case of ACL-reconstruction and the efficacy for: pain relief; enhancement of the range of motion of the knee; enrichment of the functional capacity; amelioration of the neuro-muscular coordination; stabilization of the gait; improvement of the quality of life.

Keywords: Rehabilitation; Anterior Cruciate Ligament; Physical Medicine; Electrotherapy; Magnetic Field; Deep Oscillation; Laser

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Citation

Citation: Ivet Koleva and Borislav Yoshinov. “Rehabilitation Program after Post-Traumatic Reconstruction of the Anterior Cruciate Ligament (With a Clinical Case Report)". Acta Scientific Orthopaedics 3.5 (2020): 26-32.

Copyright

Copyright: © 2020 Ivet Koleva and Borislav Yoshinov. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.