REHABILITATION OF PATIENTS AFTER LIGAMENTOPLASTY OF THE ANTERIOR CRUCIATE LIGAMENT OF THE KNEE - ST GRAFT

Prednji križni ligament je vrlo snažan unutarnji ligament koljena, čije ozljede viđamo često u sportaša (bilo profesionalnih ili rekreativnih), a nakon kojih je oporavak redovito dug i kompliciran. Ruptura prednjeg križnog ligamenta predstavlja jednu od najčešćih povreda koljenog zgloba kod sportaša profesionalaca, ali i onih koji se sportom bave povremeno, rekreativno. ACL sprječava da zglobna glavica ne «pobjegne» prema naprijed pri mnogobrojnim , kako u sportskim aktivnostima, tako i van njih. Mehanizam ozljede, odnosno puknuća ACL-a zasnovan je na traumi i to takvoj koja vanjske sile usmjerava prema koljenu u smislu njegova forsiranog opružanja i rotacije. Primjeri za to su mnogobrojni, od pada pri skijanju, doskoka u odbojci, promjene pravca pri napadu u rukometu, pa sve do udaraca ili blokade potkoljenice u situacijama dok je tijelo još u pokretu (borilački sportovi, uklizavanje u nogometu i sl.). Najčešće je pri samoj ozljedi prisutna iznimno intenzivna bol praćena nastajanjem otoka i smanjenom pokretljivošću koljena. Za prvu pomoć treba upotrijebiti led kako bi se smanjila bolnost, te učiniti kompresiju elastičnim zavojem, a sve u nastojanju da se smanji nastajanje otoka. Nakon toga valja točno dijagnosticirati nastalu ozljedu bilo putem provođenja specijalnih testova ili putem MR-a. Nakon potvrđene dijagnoze slijedi liječenje koje kod ovakvog tipa oštećenja nije nimalo jednostavno a ni kratko. Liječenje može biti konzervativno koje traje otprilike 12 tjedana ili operativno uz pomoć kirurške rekonstrukcije ligamenta pomoću tetiva mišića semitendinosusa i gracilisa. Oporavak nakon operacije dijelimo na preoperativni i postoperativni tijek u trajanju do 6 mjeseci ili duže.Anterior cruciate ligament is very strong inner knee ligament, whose injuries we often see in athletes (whether professional or recreational), after which recovery is regularly long and complicated. Rupture of the anterior cruciate ligament is one of the most common knee injuries in athletes, professionals, and those who engage in sport occasionally, recreationally. ACL prevents the joint head is not "escape" forward in many, both in sporting activities, and elsewhere. The mechanism of injury, or rupture of the ACL is based on trauma and such that an external force is directed towards the knee in terms of its forced by stretching and rotation. Examples of this are numerous, from the fall while skiing, landing in volleyball, lane changing attack in handball, to strokes or blockages in the shins situations while the body is in motion (martial arts, carve it in football, etc..). The most common injury in the present extremely intense pain accompanied by the formation of islands and reduced mobility knees. First aid should be used ice to reduce pain and make the compression elastic bandage, all in an effort to reduce the formation of the island. After that, it should be accurately diagnose the injury was caused by conducting special tests or by MRI. After confirmation of the diagnosis, treatment follows that in this type of damage is not simple nor short. Treatment can be conservative, which lasts about 12 weeks or operationally with the help of surgicalreconstructionofthe ligament using tendons of semintendinosus and gracilis musculature. Recovery after surgery is divided into preoperative and postoperative period lasting up to 6 months or longe