Laxity of reconstructed anterior cruciate ligament of the knee: considerations to the physiotherapy plan and return to play of the athletes

Abstract

Introduction: It has been repoirted that over 70% of anterior cruciate ligament (ACL) injuries occur in noncontact situations during professional and recreational sport activities. In most cases injury requires surgery and the reconstruction of torn ACL. The rehabilitation takes aabout 6-9 months and the athlete is ready to return to play in about 81% cases. Another frightening fact is that kids ACL injury rates grown up to 400% over the last ten years. Anterior cruciate ligament rupture leads to the front - lateral knee joint instability, quadriceps muscle atrophy, joint surface degeneration, meniscus injuries and the recurrent pain. The main problems arising for the following reasons: knee proprioception dysfunction, balance impairment and gait dysfunction, a lot of difficulties in casual activity, especially in sport and physical activities. In a "normal" body, ligaments (which are the tissues that connect bones to each other) are naturally tight in such a way that the joints are restricted to "normal" ranges of motion. This creates normal joint stability. Proper physiotherapy plan after the ACL reconstruction gives about 50% of success in return to play. Latest trends in the physiotherapy of the athletes suggest criterion-based rehabilitation plan over the time-based rehabilitation. The aim of the study was to evaluate laxity of the reconstructed ACL 3, 6 and 12 months after the surgery in professional or recreational athletes. Material and method: The knee laxity was measured with robotic laximeter Genourob. The GNRB® is a knee laxity testing device for measurement of anteroposterior tibial translation at 20° of knee flexion thus reproducing the Lachman test position. A linear jack exerts gradually increasing thrust forces according to the examiner on the upper section of the calf. Laxity (mm of movement of the proximal tibia in the anterior direction relative to the femur) was calculated at test forces of 134 N, 150 N, 200 N and 250 N. [...].