Primerjava izidov operativnega in konzervativnega zdravljenja rupture zadnje križne vezi - pregled literature : diplomsko delo

Kermavner, Katarina Nina (author), Vauhnik, Renata (mentor), Grapar Žargi, Tina (co-mentor), Hlebš, Sonja (reviewer)

Uvod: Pretrganje zadnje križne vezi velja za izredno redko poškodbo, ki pa je bila v preteklosti večkrat spregledana in imela posledično bistveno manj pozornosti od drugih poškodb vezi kolenskega sklepa. Zaradi nastalih pomanjkljivosti pri raziskovanju, ostaja tema zdravljenja popolnih pretrganj zadnje križne vezi med strokovnjaki dokaj kontroverzna. Zadnje desetletje predstavlja velik doprinos k boljšemu razumevanju anatomije in biomehanike zadnje križne vezi, posledično pa tudi napredek pri operativnih tehnikah in boljše možnosti za nastanek primernih protokolov rehabilitacije. Kljub večji pozornosti pa še vedno ni konsenza ter jasnih smernic glede primernosti zdravljenja pretrganj zadnje križne vezi. Namen: Namen diplomskega dela je, na podlagi pregleda strokovne in znanstvene literature, primerjati učinkovitost konzervativnega in operativnega zdravljenja pacientov po pretrganju zadnje križne vezi. Metode dela: Uporabljena je bila metoda pregleda literature obravnavane teme. Primerne vire smo iskali s pomočjo elektronskih zbirk na strani PubMed s kombinacijo naslednjih ključnih besed v angleškem jeziku: (“PLC rupture” OR “posterior cruciate ligament rupture”) AND (“conservative treatment of PCL rupture”) AND (“PCL reconstruction” OR “operative treatment of PCL rupture” OR “PCLR outcomes”). Iskanje literature je bilo izvedeno med decembrom 2019 in oktobrom 2020 ter časovno omejeno na vire, objavljene od januarja 2005. Rezultati: V pregled literature je bilo skupno vključenih 444 preiskovancev iz devetih raziskav. Do statistično pomembne razlike v posteriorni translaciji je prišlo pri eni raziskavi, ki je preučevala učinke konzervativnega ter pri štirih raziskavah, ki so preučevale učinke operativnega zdravljenja. Razprava in zaključek: Rezultati našega pregleda literature opozarjajo na pomanjkanje z dokazi podprtih raziskav predvsem pri popolnih izoliranih pretrganjih zadnje križne vezi, kjer so nestrinjanja o primerni izbiri zdravljenja med strokovnjaki močno prisotna. Za lažjo primerjavo rezultatov bi bilo v prihodnje smiselno učinke obeh vrst zdravljenja ocenjevati po enotnem protokolu. Hkrati pa za pridobitev natančnejših rezultatov, različne stopnje pretrganja preiskovati v ločenih raziskavah.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, pretrganje zadnje križne vezi, posteriorna translacija, osteoartroza, imobilizacija kolenskega sklepa
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [K. N. Vrbinc]
• Year: 2021
• Number of pages: 33 str.
• PID: 20.500.12556/RUL-131408
• UDC: 615.8
• COBISS.SI-ID: 77882371
• Publication date in RUL: 26.09.2021

Secondary language

• Language: English
• Title: Comparison of surgical and conservative treatment outcome of posterior cruciate ligament rupture - literature review : diploma work

Abstract

Introduction: Rupture of posterior cruciate ligament is considered an extremely rare injury, that has been overlooked in the past and consequently received significantly less attention when compared with other knee ligament injuries. Due to low volume of the research, there is a lot of controversy among scientists when it comes to total cruciate ligament rupture treatments. Studies found in the last decade have been a major contribution to posterior cruciate ligament anatomy and biomechanics, which also brings better operative techniques and development of an appropriate rehabilitation protocol. However, the guidelines for a proper posterior cruciate ligament rupture treatment have still not been agreed upon. Purpose: The purpose of our study is to compare the outcomes of conservative and operative treatment after posterior cruciate ligament ruptures based on professional and scientific literature. Methods: Our study is a literature review. The search for eligible studies was conducted with electronic database PubMed with combination of the following keywords: (“PLC rupture” OR “posterior cruciate ligament rupture”) AND (“conservative treatment of PCL rupture”) AND (“PCL reconstruction” OR) (Operative treatment of PCL rupture ”OR“ PCLR outcomes ”). The search for literature was conducted between December 2019 and October 2020 and limited to studies published after January 2005. Results: A total of 444 subjects from nine studies were included in this literature review. There was a statistically significant decrease in posterior translation in one conservative study and four operative studies. Discussion and conclusion: The results of our literature review show lack of evidence-based studies, particularly in total isolated cruciate ligament ruptures, where disagreements about a proper treatment choice among professionals are strongly present. In order to properly compare the results in the future studies, it would be reasonable to evaluate the effects of both types of treatment according to a single protocol, and study different grades of posterior cruciate ligament ruptures separately, to obtain more accurate results.

• Keywords: diploma theses, physiotherapy, posterior cruciate ligament rupture, posterior translation, osteoarthritis, knee joint immobilization