前交叉韧带重建后移植物愈合和功能恢复:康复训练个案观察

Graft healing and functional recovery after anterior cruciate ligament reconstruction: a case study of rehabilitation training

背景:前交叉韧带的损伤将直接影响到个体的下肢功能,对运动员而言更为严重,前交叉韧带重建术后的康复训练是否合理、有效,是否可以恢复膝关节的正常功能甚为重要。目的:探究康复训练对前交叉韧带重建术后移植物愈合及膝关节功能恢复的影响。方法:以1名国家男子橄榄球队优秀运动员为个案研究,对其前交叉韧带重建术后进行分阶段系统的康复训练,康复前后拍摄MRI,分别进行关节屈曲度、腿部围度、下肢等速力量、YBT测试、BESS测试、前馈测试、单脚静态平衡测试、双脚动态平衡测试、Lysholm膝关节评分、上肢无氧功、躯干力量等检测,分析康复训练对运动员前交叉韧带重建术后移植物愈合情况、身体形态、膝关节功能和身体素质的积极影响。结果与结论:通过术后10个月的分阶段康复训练,运动员前交叉韧带重建术后移植物愈合良好,膝关节屈曲度恢复正常,膝关节水肿基本消除,膝关节伸屈肌力量恢复到受伤前的95%以上,膝关节功能测试良好,关节功能也恢复了较高水平,Lysholm膝关节评分85分,上肢无氧功和躯干力量达到受伤前的120%,身体各项素质较受伤前有了较大提高。此次的康复训练对运动员前交叉韧带损伤重建术后移植物愈合、膝关节功能、肌肉力量和身体素质恢复有较好的促进作用。

BACKGROUND:Anterior cruciate ligament(ACL)injury directly impacts the individual's lower limb function.It is very important for althelets whether rehabilitation training after ACL reconstruction is reasonable,effective and can restore the normal function of the knee joint.OBJECTIVE:To explore the effect of rehabilitation training on graft healing and knee joint function recovery after ACL reconstruction.METHODS:An elite rugby player was enrolled and subjected to phased rehabilitation training after ACL reconstruction.MRI examination was done before and after rehabilitation training.Then,the following indicators were tested,including joint flexion of knee,leg circumference degrees,isokinetic muscle strength of the lower limb,feedback test,the test of YBT,the Balance Error Scoring System,feedforward test,static balance test on one foot,dynamic balance test on the feet,Lysholm knee score,anaerobic work of the upper extremity,torso strength,to analyze the graft healing,body shape,the knee joint function and physical quality improvement after ACL reconstruction.RESULTS AND CONCLUSION:After 10 months of phased rehabilitation training,the graft healed well;the knee flexion degree was back to normal;knee joint swelling basically eliminated;the muscle strength of the extensor flexor of the knee joint was back to over 95%of the normal level;the function of the injured knee joint was good and returned to a higher level;the Lysholm knee score was 85 points;the anaerobic work of the upper limbs and trunk strength reached to 120%of the normal level;and the quality of the body was greatly improved.To conclude,a great improvement in graft healing,knee joint function,recovery of muscle strength and physical qualities has been achieved in athletes who receive rehabilitation training after ACL reconstruction.