Di̇lber KARAGÖZOĞLU COŞKUNSU, VOLGA BAYRAKCI TUNAY, Işık AKGÜN

Current trends in reconstruction surgery and rehabilitation of anterior cruciate ligament in turkey

Amaç: Bu çalışmada Türk ortopedik cerrahlar tarafından yapılan ön çapraz bağ (ÖÇB) tamirinde kullanılan son cerrahi teknikler ve rehabilitasyon protokolleri bildirilerek, sonuçları “ÖÇB Çalışma Grubu” ile karşılaştırıldı. Çalışma planı: Cerrahi yöntemleri, cerrahinin önkoşulları, cerrahi sonrası rutin uygulamalar, rehabilitasyon yaklaşımları ve spora dönüşle ilgili bilgi almak üzere 16 sorudan oluşan bir anket hazırlanarak, yılda 25 ve üzeri ÖÇB tamiri yapan 55 ortopedik cerraha e-posta yolu ile gönderildi. Sonuçlar: Anketin yanıtlanma oranı %70.9 (n=39) idi. Ondokuz cerrah (%48.7) sadece hamstring tendon (HT) grefti, dört cerrah (%10.3) sadece patellar tendon (PT) grefti, 16 cerrah (%41) hem HT hem de PT grefti kullanmakta idi. Hem HT hem de PT greft kullanan 16 cerrahtan dördünün (%18.8) iki greft tipi için ayrı rehabilitasyon protokolleri vardı. Spesifik aktivitelere başlama zamanları karşılaştırıldığında iki greft tipi için verilen cevaplar arasında istatistiksel olarak anlamlı fark yoktu (p>0.05). Rehabilitasyon protokolleri “ÖÇB Çalışma Grubu”nun son verileri ile benzerlik göstermekte idi. Türk cerrahlar ve “ÖÇB Çalışma Grubu” arasında sürekli pasif hareket (continuous passive motion, CPM) cihazı ve postoperatif breys kullanımı açısından fark vardı. Cerrahi sonrası breys ve CPM cihazı kullanımı Türkiye’de daha yaygındı. Çıkarımlar: Türk ortopedik cerrahların HT ve PT greft ile yaptıkları ÖÇB tamirinin cerrahi sonrası yaklaşımı çok az farklılık göstermektedir. Türk ortopedik cerrahlardan elde edilen veriler “ÖÇB Çalışma Grubu” güncel yaklaşımları ile benzerlik göstermektedir.

Türkiye’de ön çapraz bağ rekonstrüksiyonu cerrahisi ve rehabilitasyonundaki güncel yaklaşımlar

Objectives: This study aims to determine the current approaches to surgical techniques and rehabilitation protocols used in anterior cruciate ligament (ACL) reconstruction performed by Turkish orthopedic surgeons and to compare their results with the data of “ACL Study Group”. Methods: A questionnaire consisting of 16 questions on surgical techniques, preoperative prerequisites, routine postoperative applications, rehabilitation approaches, and return to sport following ACL reconstruction was sent via e-mail to the 55 orthopedic surgeons performing annually 25 or more ACL reconstructions. Results: Response rate to questionnaire was 70.9% (n=39). Nineteen surgeons (48.7%) regularly performed only hamstring tendon (HT) graft, and four surgeons (10.3%) performed only patellar tendon (PT) graft, while 16 surgeons (41%) performed both HT and PT grafts. Three (18.8%) of the 16 surgeons who performed both HT and PT grafts had individual rehabilitation protocols for the two graft types. No statistically significant difference was found between the responses for two graft types in terms of the starting times for specific activities (p>0.05). Rehabilitation protocols were similar to the current data of “ACL Study Group”. The use of a postoperative brace and continuous passive motion (CPM) was different between Turkish surgeons and “ACL Study Group”. The CPM and postoperative brace use was more common in Turkey. Conclusion: There are only a few differences in the postoperative approach of ACL reconstruction with HT and PT grafts performed by Turkish orthopedic surgeons. The data obtained from the Turkish orthopedic surgeons showed similarities with the “ACL Study Group” current approaches

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