SABRİYE ERCAN, Hilmi Mustafa DEMİR, YurdagülBaygül ATALAY, Ozan TURGAY, TOLGA ATAY, CEM ÇETİN

Ön Çapraz Bağ Rekonstrüksiyonu Sonrası Spora Geri Dönüş Kararında Kontralateral Ekstremiteyi Referans Almak Yeterli Mi?

Ön çapraz bağ (ÖÇB) yaralanması, kas kuvvetinin azalmasına ve instabilite gelişmesine bağlı olarak uyluk kaslarının fonksiyonunu olumsuz yönde etkilemektedir. Literatürde spora geri dönüş kriteri içinde alt ekstremite simetri indeksini sağlamış olmak koşulu bulunmaktadırBu çalışmamanın amacı; ÖÇB rekonstrüksiyonu sonrası normal diz fonksiyonlarını kazanan hastaların verilerini, nonopere tarafları ve alt ekstremite yaralanması geçirmeyen bireylerin verileri ile karşılaştırarak spora geri dönüş kriteri olarak belirtilen kontralateral ekstremiteye göre simetri sağlamanın yeterliliğini araştırmaktır. 14 sağlıklı erkek ile unilateral ÖÇB rekonstrüksiyonu geçiren 15 erkek hasta çalışmaya katıldı. Çalışmamızda Tegner aktivite seviyesi, Lysholm diz puanı ve aktif eklem hareket açıklığı ölçüldü; tek bacak hoplama testi, flamingo denge testi, izokinetik kas kuvveti ve propriosepsiyon testi uygulandı. Gruplar arasında demografik veriler, aktivite düzeyi ve diz skorları açısından istatistiksel anlamlı farklılık yoktu (p>0,05). 30?'deki pasif eklem pozisyon duyusu testinde opere ve nonopere diz arasında opere diz lehine istatistiksel anlamlı farklılık tespit edildi (p

Are Contralateral Extremity References Adequate To Take Decision For Return To Play After Anterior Cruciate Ligament Reconstruction?

Anterior cruciate ligament (ACL) plays an important role in maintaining the function of the knee. In case of injury declining of the muscle strength and unstability of the knee occurs which affects the thigh muscle functions in a bad way. In the literature, it is necessary to provide the lower extremity symmetry index for return to playPurpose of this study is, compare ACL recontructed patients’ data, who have normal knee functions according to return to play guideline, to their health extremity and to noninjuered healthy subjects’ data. To investigate the adequacy of providing symmetry with respect to the contralateral extremity specified as return to play. 14 healthy male subject and 15 unilaterally ACL reconstructed patient enrolled into the study. Tegner activity scale, Lysholm Knee Score and active range of motions were evaluated. Single leg hop test, flamingo balance test, isokinetic test and proprioceptive evaluations were done too. There were no statistically significant differecences demographical datas, activity levels and knee scores between groups (p>0,05). Passive joint sense at 30˚ has statistically significant difference between operated and nonoperated knee (p

PDF

___

1.Herrington L, Wrapson C, Matthews M, Matthews H. Anterior Cruciate Ligament reconstruction, hamstring versus bone–patella tendon–bone grafts: a systematic literature review of outcome from surgery. The Knee 2005; 12(1): 41 -50.
2.Frobell RB, Roos HP, Roos EM, Roemer FW, Ranstam J, Lohmander LS. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ 2013; 346: 1-12.
3.Li S, Su W, Zhao J, Xu Y, Bo Z, Ding X, Wei Q. A meta-analysis of hamstring autografts versus bone– patellar tendon–bone autografts for reconstruction of the anterior cruciate ligament. The Knee 2011;18(5): 287-93.
4.Van Ginckel A, Verdonk P, Victor J, Witvrouw E. Cartilage status in relation to return to sports after anterior cruciate ligament reconstruction. AJSM 2013; 41(3):550-9.
5.Jang SH, Kim JG, Ha JK, Wang BG, Yang SJ. Functional performance tests as indicators of returning to sports after anterior cruciate ligament reconstruction. The Knee 2014;21(1):95-101.
6.Ayeni OR, Chahal M, Tran MN, Sprague S. Pivot shift as an outcome measure for ACL reconstruction: a systematic review. Knee Surg, Sports traumatol, Arthrosc 2012;20(4): 767-77.
7.Benjaminse A, Gokeler A, van der Schans CP. Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther 2006;36 (5):267-88.
8.Tsepis E, Giakas G, Vagenas G, Georgoulis A. Frequency content asymmetry of the isokinetic curve between ACL deficient and healthy knee. J Biomech 2004;37(6): 857-64.
9.Siegel L, Vandenakker-Albanese C, Siegel D. Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management. Clin J Sport Med 2012;22(4):349-55.
10.Petersen W, Taheri P, Forkel P, Zantop T. Return to play following ACL reconstruction: a systematic review about strength deficits. Arch Orthop Trauma Surg 2014;134(10): 1417-28.
11.Ardern CL, Taylor NF, Feller JA, Whitehead TS, Webster KE. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. AJSM 2013;41(7):1549-58.
12.Kong CG, In Y, Kim GH, Ahn CY. Cross pins versus endobutton femoral fixation in hamstring anterior cruciate ligament reconstruction: minimum 4-year follow-Up. Knee Surg relat Res 2012;24(1): 34-9.
13.Harris JD, Abrams GD, Bach BR, Williams D, Heidloff D, Bush-Joseph CA, et al. Return to sport after ACL reconstruction. Orthopedics 2014;37(2):103-8.
14.Myer GD, Martin L, Ford KR, Paterno MV, Schmitt LC, Heidt RS, Colosimo AJ, et al. No association of time from surgery with functional deficits in athletes after anterior cruciate ligament reconstruction evidence for objective return-to-sport criteria. AJSM 2012;40(10):2256-63.
15.Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, Tsepis E, et al. Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg, Sports traumatol, Arthrosc 2011;19(11): 1798-805.
16.Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum 2010;40 (3):250-266.
17.Myer GD, Paterno MV, Ford KR, Quatman CE, Hewett TE. Rehabilitation after anterior cruciate ligament reconstruction: criteria-based progression through the return-to-sport phase. JOSPT 2006;36(6): 385-402.
18.Streich NA, Reichenbacher S, Barié A, Buchner M, Schmitt H. Long-term outcome of anterior cruciate ligament reconstruction with an autologous four- strand semitendinosus tendon autograft. Int Orthop 2013;37(2): 279-84.
19.Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, et al. SingleLegged Hop Tests as Predictors of Self-Reported Knee Function After Anterior Cruciate Ligament Reconstruction The Delaware-Oslo ACL Cohort Study. AJSM 2012; 40(10): 2348-56.
20.Hrysomallis C. Relationship between balance ability, training and sports injury risk. Sports Med 2007;37(6): 547-56.
21.Zaffagnini S, Grassi A, Muccioli GM, Tsapralis K, Ricci M, Bragonzoni L, Villa SD, et al. Return to sport after anterior cruciate ligament reconstruction in professional soccer players. The Knee 2014;21 (3):731-5.
22.Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE. Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport. Clin J Sport Med 2012;22(2): 116.
23.Schmitt LC, Paterno MV, Hewett TE. The impact of quadriceps femoris strength asymmetry on functional performance at return to sport following anterior cruciate ligament reconstruction. JOSPT 2012;42(9): 750-9.
24.Brophy RH, Schmitz L, Wright RW, Dunn WR, Parker RD, Andrish JT, McCarty EC, et al. Return to play and future ACL injury risk after ACL reconstruction in soccer athletes from the Multicenter Orthopaedic Outcomes Network (MOON) group. AJSM 2012;40(11):2517-22.
25.Laboute E, Savalli L, Puig P, Trouve P, Sabot G, Monnier G, Dubroca B. Analysis of return to competition and repeat rupture for 298 anterior cruciate ligament reconstructions with patellar or hamstring tendon autograft in sportspeople. Ann Réadaptation Méd Phys 2010;53(10):598-614.
26.Roberts D, Ageberg E, Andersson G, Fridén T. Clinical measurements of proprioception, muscle strength and laxity in relation to function in the ACL- injured knee. Knee Surg, Sports traumatol, Arthrosc 2007;15(1):9-16.
27.Chouteau J, Testa R, Viste A, Moyen B. Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction. Knee Surg, Sports traumatol, Arthrosc 2012;20(4):762-6.
28.Nagai T, Heebner NR, Sell TC, Nakagawa T, Fu FH, Lephart SM. Restoration of sagittal and transverse plane proprioception following anatomic double-bundle ACL reconstruction. Knee Surg, Sports traumatol, Arthrosc 2013;21(9):2048-56.
29.Fremerey RW, Lobenhoffer P, Zeichen J, Skutek M, Bosch U, Tscherne H. Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament a prospectıve, longıtudınal study. J Bone Joint Surg British, 2000;82(6):801-6.
30.Arockiaraj J, Korula RJ, Oommen AT, Devasahayam S, Wankhar S, Velkumar S, Poonnoose PM. Proprioceptive changes in the contralateral knee joint following anterior cruciate injury. Bone Joint J 2013;95(2):188-91.