Author/Editor		Fokter, Samo K; Sajovic, Matjaž; Vengust, Vilibald; Kotnik, Marko
Title		Kirurško zdravljenje omejene gibljivosti kolena po rekonstrukciji srednje križne vezi
Translated title		Surgical treatment of loss of motion after anterior cruciate ligament reconstruction
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 66, št. 7-8
Publication year		1997
Volume		str. 405-8
Language		slo
Abstract		Background. Loss of motion is a complication following anterior cruciate ligament (ACL) reconstruction, which substantially compromises the result of operative treatment of un unstable knee. This retrospective study was designed to clarify the causes and incidence of this complication on one hand, and to evaluate the results of arthroscopic treatment on our patient population on the other. Methods. In a series of 200 consecutive open ACL reconstructions with autologus middle third bone - patellar tendon - bone graft, eight (study group) required further surgical treatment due to restricted knee motion. Patients scored their knees numerically using identical questionnaires (Lysholm knee score) before and after reoperation. They also graded their sports activity level according to the level before primary knee injury. Clinically, range of motion and stability were tested, and KLT arthrometer results were recorded. Signs of arthrosis and patellar high were measured radiographicaly. Results were compared with the sport activity level and numerical questionnaires (questionnaire group), filled-in and returned from 119 patients (121 knees). From all operated patients, twenty were selected at random for additional clinical, KLT and radiographic measurements (control group). Results. The ACL reconstruction was done in the study group an average of eight weeks after injury, and far later, an average of 22 months after injury in the control group. Mean age of patients at the time of reconstruction in the study group was 34 years and those in control group 26. After reoperation, the functional outcome scores of the two groups were statistically the same. Conclusions. Loss of motion after ACL reconstruction has an incidence of 4% in our series. It is more common in older patients and those operated early after injury. it is worthwile to treat the complication surgically. The results of reoperation are good.
Summary		Izhodišča. Omejena gibljivost kolena po rekonstrukciji sprednje križne vezi (SKV) je zaplet, ki bistveno vpliva na rezultat operativnega zdravljenja nestabilnega kolena. S pričujočo retrospektivno študijo smo želeli razjasniti vzroke in pogostost pojavljanja, kakor tudi ovrednotiti rezultate artroskopskega zdravljenja tega zapleta pri naši populaciji bolnikov. Metode. V skupini 200 zaporednih odprtih transtendinoznih rekonstrukcij SKV z avtolognim presadkom srednje tretjine pogačične tetive je bilo osem bolnikov (študijska skupina) ponovno zdravljenih operativno zaradi omejene gibljivosti kolena. Pred reoperacijo in po njej so se bolniki ocenili z identičnim Lysholmovim numeričnim vprašalnikom ter določili raven svoje športne aktivnosti glede na tisto pred primarno poškodbo kolena. Klinično smo jim izmerili gibljivost in stabilnost, ki smo jo dodatno ovrednotili z aparatom KLT. Rentgenološko smo iskali znake artroze in izmerili višino pogačice. Rezultate smo primerjali z ravnijo športne aktivnosti in numeričnim vprašalnikom (skupina z vprašalnikom), ki nam ga je izpolnjenega vrnilo 119 bolnikov (121 kolen). Izmed vseh operiranih bolnikov smo naključno izbrali vzorec dvajsetih za dodatno klinično testiranje, rentgenološke in KLT meritve (kontrolna skupina). Rezultati. rekonstrukcija SKV je bila v študijski skupini napravljena povrečno osem tednov po poškodbi, v kontrolni skupini pa povrečno 22 mesecev po poškodbi. Povprečna starost bolnikov v študijski skupini je znašala 34 in v kontrolni skupini 26 let. Po reoperaciji se funkcionalni rezultati študijske in kontrolne skupine statistično niso razlikovali. Zaključki. Zmanjšana gibljivost kolena po rekonstrukciji SKV se v naši seriji pojavlja v 4% primerov. Pogostejša je pri starejših bolnikih in tistih, ki so obravnavani kmalu po poškodbi. Zaplet je smiselno reŠevati operativno, uspeh reoperacije je dober.
Descriptors		ANTERIOR CRUCIATE LIGAMENT POSTOPERATIVE COMPLICATIONS FIBROSIS ARTHROSCOPY KNEE INJURIES TENDON TRANSFER REOPERATION