The Study Of Exercise Rehabilitation After Anterior Cruciate Ligament Reconstruction

ObjectiveTo analyze retrospectively the effect of different methods of exercise rehabilitation after anterior cruciate ligament reconstruction on the knee stability and function, and to find a better rehabilitation programme.MethodsWe retrospectively summaried the clinical data on the 104 our hospital in-patient with anterior cruciate ligament (ACL) injury during July,2005 to july,2009, who were followed up over 18 months. All patients received arthroscopic ACL reconstruction operative, who received arthroscopic partial meniscectomy or if his meniscus torn, who received radio frequency current ablation if his bone bruise. According to different rehabilitation methods and whether strictly accomplishing rehabilitation programme they were divided into 3groups:aggressive rehabilitation group as modified rehabilitation one including 39patients; conservative rehabilitation group as traditional one including 34 patients; 31 patients not accomplishing rehabilitation programme as the rest group.At post-op 6,12,18 months we assessed of rehabilitation effect,and compared rehabilitation index.Mainly rehabilitation index included: 1 general state of patients,2 degree of satisfaction of rehabilitation,3range of motion of knee join,4 stability of the knee,5 thigh circumference,6 Lysholm score,7 IKDC score.ResultAll patients received successful operation,the length of transplants ligament was equilong reconstruction, fit the bone tunnel, and fixed forcefully.1. general state of patientsEach patient in hospitalization days, operation time, the number of cases of out effusion articular cavity puncture of lower extremities(1 and over 1 time), hot days, the number of cases venous thrombosis see table 2:by statistical test: the three groups have significant differences in operation time(P<0.05). Refer to means of each groups, the radical therapy groups have the shortest hospitalization time, The unrecoveried groups have the longest hospitalization time. The three groups have no significant differences in operation time, the number of cases of out effusion articular cavity puncture of lower extremities, hot days, the number of cases venous thrombosis (P>0.05)2. degree of satisfaction of rehabilitationThe satisfaction of rehabilitation program for patients in the two groups see table 3, by statistical analysis:the satisfaction of the radical therapy groups have great superior to conservative treatment groups in 1 month and 3 months(P<0.05). The satisfaction of the two groups have no differences in 6 months,12 months,18months(P>0.05).3.range of motion of knee joint (ROM)The unrecoveried groups in limit degree of unbend and bend to knee joint in post-operative 6 months,12 months,18 months, have great superior to the radical therapy groups and conservative treatment groups (P<0.05). Between the radical therapy groups and conservative treatment groups have no significant differences to each time in limit degree of unbend and bend to knee joint (P>0.05).4. stability of knee jointThe unrecoveried groups have 6 cases,8 cases,9 cases, who has the positive result with Lachmann test in post-operative 6 months,12 months,18 months, have great superior to the radical therapy groups (1 case,2 cases,2 cases, respective)and conservative treatment groups(1 case,2 cases,2 cases, respective)(P<0.05). Between the radical therapy groups and conservative treatment have no significant differences(P>0.05). The unrecoveried, groups have 7 cases,9 cases,9 cases, who has the positive result with pivot shift test in post-operative 6 months,12 months,18 months, have great superior to the radical therapy groups (1 case,2 cases,2 cases, respective)and conservative treatment groups(2 case,3 cases,3 cases, respective)(P<0.05). Between the radical therapy groups and conservative treatment have no significant differences(P>0.05)5. thigh circumference The three pre-operative groups have no significant differences in D-value of thigh circumference (P>0.05). the three groups of post-operative 6 months,12 months,18 months have a significant differences in D-value of thigh circumference compared with pre-operation(P<0.05). Refer the D-value means of each group, the D-value of thigh circumference which between injured thighs and uninjured thighs great less than pre-operation(P<0.05). The groups of both radical therapy and conservative treatment have a significant differences in the D-value of thigh circumference compared with the unrecoveried groups(P<0.05). the radical therapy and conservative treatment groups of post-operative 6 months,12 months,18 months have no significant differences in in the D-value of thigh circumference (P>0.05).6.Lysholm scoreThe three pre-operative groups have no significant differences in Lysholm score(P>0.05),the three groups of post-operative 6 months,12 months,18 months have a significant differences in Lysholm score compared with pre-opera tion(P<0.05).The groups of both radical therapy and conservative treatment have a significant differences in Lysholm score compared with the unrecoveried groups(P<0.05).the radical therapy and conservative treatment groups of post-operative 6 months,12 months,18 months have no significant differences in Lysholm score(P>0.05).7.IKDC scoreThe three pre-operative groups have no significant differences in IKDC score(P>0.05),the three groups of post-operative 6 months,12 months,18 months have a significant differences in IKDC score compared with pre-operation (P<0.05).The groups of both radical therapy and conservative treatment have a significant differences in IKDC score compared with the unrecoveried groups(P<0.05).the radical therapy and conservative treatment groups of post-operative 6 months,12 months,18 months have no significant differences in IKDC score(P>0.05).Conclusion1.The rehabilitation program established in this study to fuctional recovery after the operation of ACL ingury has a fine effect and safety.2. From short-term curative effect analysis, radical therapy and conservative treatment for ACL reconstruction have no difference in functional recovery effect which knee damaged between 12 months with 18 months.3. From the patient compliance, hospitalization time and clinical efficacy analysis, ACL reconstruction after surgery patients suggests to select radical therapy which established in this study.