关节镜下膝前交叉韧带重建术后的康复

探讨安全有效的前交叉韧带重建术后康复。方法:膝关节前交叉韧带(ACL)重建(BPTB)患者60例,按照我中心现行康复程序进行功能锻炼。术后1年进行关节活动度、肢体围度测量及问卷调查。使用等张肌力测试系统对术后3个月后坚持练习和未坚持练习患者各10例,评定双侧腿肌力,比较各项参数。结果:全部患者术后3个月恢复全范围AROM、正常ADL及患膝屈肌肌力,6—7个月恢复正常运动,大部分专业运动员恢复原有竞技性运动水平。术后坚持练习组与未坚持练习组肌力比较,伸肌最大输出功率、最大收缩速率、最大力量存在显著差异(P<0.05),伸肌疲劳系数及屈肌力量无显著差异(P>0.05)。术后1年,大腿及小腿围度较健侧有显著差异(P<0.01,P<0.05)。结论:ACL重建术后康复治疗程序安全有效,患者短期(3个月)可恢复正常AROM、ADL及患腿屈肌肌力,并逐步恢复正常运动。膝伸肌肌力需坚持长期练习,才可更好恢复。

Rehabilitation treatment for knee arthroscopic reconstruction of anterior cruciate ligament by autogenous patellar tendon

Objective:To explore the rehabilitation treatment for ACL postoperative reconstruction.Method:ACL reconstruction were preformed arthroscopically with antogenous bone-patellar tendon-bone(BPTB)in60patients.The exercises were performed as following:isometric exercises were started at the operation day,weight bearing at2days after operation,passive ROM exercises at3days postoperatively.Muscles strength training and ROM exercises were increased during2-3months.Sport was allowed at4months.The ROM and girth of leg were evaluated and the situation of the function was investigated at1year.10patients randomly selected who persisted in exercises3months post operation,and another10patients who did not do it were assessed of isotonic muscle strength with EN-Tree M Explosive pulley(Enraf-Nonius2000).All of the indexes were compared.Result:All patients had recovered with normal ADL and full AROM and muscle strength of knee flexion3months after operation,and returned to sports at6-7th months.Mostly athletes had returned to the special sports.The peak power,peak velocity and peak force of knee extension had a significant differences(P<0.05)between the patients with or without exercises.Fatigue index and muscle strength of knee flexion had no significant differences(P>0.05).Girth of thigh and calf had a significant differences(P<0.01,P<0.05)at1st year.Conclusion:Our rehabilitation treatment is safe and efficacious.All of patients can recover AROM,ADL function and muscle strength of knee flexion complete,but the extension need more exercise.