Exercise planning after revision anterior cruciate ligament reconstruction and completed rehabilitation

Poškodbe sprednje križne vezi so zlasti pri visoko intenzivnih športih precej pogoste, posamezniki pa se po popolni raztrganini v veliki meri odločajo za njeno operativno nadomestitev oziroma rekonstrukcijo. Ker poseg pri dokaj pomembnem številu pacientov ni uspešen, je v takšnih primerih smiselna ponovna operacija, katere rezultati pa so v splošnem žal manj ugodni od tistih po prvi rekonstrukciji. Temeljni namen magistrskega dela je bil celovito predstaviti problematiko ponovne rekonstrukcije sprednje križne vezi z vidika dejavnikov neuspeha primarne operacije in indikacij za ponovno nadomestitev vezi, opisati pred- in medoperativen potek ponovne rekonstrukcije in njene rezultate, ter razdelati tako smernice oziroma okviren načrt vadbe v pooperativnem obdobju kot tudi kriterije za varno vrnitev k zahtevnejšim gibalnim oziroma športnim aktivnostim. Naš glavni cilj je bil tako zagotoviti športnim in zdravstvenim delavcem smiselno razčlenjen teoretičen vpogled v tematiko ponovne rekonstrukcije sprednje križne vezi, ter jim na ta način priskrbeti pripomoček za primere, ko pri svojem delu naletijo na posameznika z napravljenima dvema nadomestitvama enega glavnih stabilizatorjev kolenskega sklepa. Uporabili smo deskriptivno metodo dela, in sicer smo si pri izdelavi pomagali s strokovno literaturo na temo poškodb kolena, oziroma natančneje na temo raztrganin sprednje križne vezi in ponovne operativne rekonstrukcije, upoštevali pa smo le vire, pri katerih smo imeli omogočen dostop do celotnega besedila. Poglavitne ugotovitve dela so bile, da je kljub visoki zahtevnosti izvedbe ponovne rekonstrukcije sprednje križne vezi možno s primerno diagnostiko vzrokov neuspeha primarne operacije, izbiro izkušenega kirurga veščega vseh operativnih tehnik, ter ustreznim pooperativnim načrtovanjem aktivnosti, doseči zadovoljive rezultate in vrnitev k športnim dejavnostim, ob tem da je bistvenega pomena individualizacija obravnave pacientov glede na njihovo športno/delovno in kirurško anamnezo.Anterior cruciate ligament injuries are quite common particularly with high intensity sports. After rupturing their ligament, majority of patients undergo reconstructive surgery to restore knee stability. Considerable number of surgeries fail, and in these cases performance of another surgery is reasonable, but sadly results of revision anterior cruciate ligament reconstruction are generally less favourable compared to those of primary surgery. The main purpose of this master’s thesis was to thoroughly present revision anterior cruciate ligament surgery issues in terms of primary reconstruction failure factors and indications for revision procedureto describe pre- and intraoperative course of revision reconstruction and postoperative resultsand to elaborate guidelines or basic exercise program for postoperative period without neglecting the criteria for a safe return to strenuous and sporting activities. Therefore, our main goal was to provide sport and healthcare employees with logically structured theoretical insight into revision anterior cruciate ligament reconstruction topic, thus giving them a useful tool for work instances when they encounter an individual who underwent two reconstructive surgeries to one of the main knee joint stabilizers. Descriptive method was employed with the help of scientific writings regarding knee injuries, and more specifically anterior cruciate ligament ruptures and revision reconstruction surgery, only taking into account sources which enabled us full text access. Primary findings of this thesis were that despite high performance difficulty of revision anterior cruciate ligament reconstruction, with appropriate recognition of index surgery failure causes, selection of highly experienced surgeon well-versed in every surgical technique, and adequate postoperative activity planning, satisfactory results and return to sporting activities can be achieved, but only by emphasising the individualization of patient treatment taking sporting/occupational and surgical history into consideration