Oleksandr Kostrub1, Viktor Kotiuk1, Roman Blonskyi1, Liudmyla Sushchenko2, Yevgen Kachur2, Yuliia Kopochynska3, Eduard Doroshenko4
1SI “Institute of Traumatology and Orthopedics NAMS of Ukraine”, Department of Sports and Ballet Trauma, Kyiv, Ukraine
2National Pedagogical Dragomanov University, Department of Physical Therapy, Kyiv, Ukraine
3National Technical University of Ukraine "Igor Sikorsky
Kyiv Polytechnic Institute", Kyiv, Ukraine
4Zaporizhzhya State Medical University, Department of Physical Rehabilitation, Sports Medicine,
Physical Education and Health, Zaporizhzhіa, Ukraine
The Modifications of the Anterior Cruciate Ligament Rupture Physical Therapy Caused by the Anterolateral Ligament Injury
Sport Mont 2021, 19(S2), 183-187 | DOI: 10.26773/smj.210931
Abstract
The anterolateral ligament (ALL) is a rotational stabilizer of the knee joint widely investigated the last 13 years as the possible cause of some anterior cruciate ligament (ACL) reconstructions failure. ALL injuries accompany 64% of ACL ruptures. Nevertheless, there are still no publications concerning changes in the ACL rehabilitation process due to the ALL concomitant rupture. We evaluated rotational stability in 12 athletes with the ACL rupture and concomitant ALL injury or Segond fracture treated conservatively before the treatment and 3 months later. The physical therapy comprised the range of motions and strengthening exercises during the immobilization period and thereafter. As only the knee joint was immobilized the physical therapy was conducted to the adjacent joints and muscles at the very beginning. A total of 83.33% of patients became pivot-shift negative in three months. In 16.67% pivot-shift test was questionable. Lachman test remained positive in 91.67%. The ACL is a more important structure than the ALL. So, our treatment strategy focuses mainly on it. Most changes in physical therapy are the immobilization and postponed axial loading with internal rotation. But even these minor changes may influence greatly the overall stability of the knee, particularly rotational stability. It seems to be the single case series as- sessing the rotational stability recovery after the ALL rupture conservative treatment we found in the scientific literature. Immobilization and non-weightbearing for up to 6 weeks may decrease the rotational instability in con- servatively treated ALL injuries concomitant to the ACL ruptures. Further investigations of the physical therapy and rehabilitation of the anterolateral ligament injuries and Segond fractures are necessary.
Keywords
anterolateral ligament, anterior cruciate ligament, rehabilitation
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