Primerjava funkcije kolena po rekonstrukciji sprednje križne vezi in dinamični stabilizaciji po metodi Ligamys : magistrsko delo

Boštjančič, Ana (author), Vauhnik, Renata (mentor), Ravnikar, Gregor (comentor), Kacin, Alan (reviewer)

Uvod: Dinamična stabilizacija ligamenta je novejša tehnika obravnave pretrgane sprednje križne vezi, ki se je razvila zaradi pomanjkljivosti, ki so se pokazale pri zdravljenju s postopkom rekonstrukcije. Tehnika Ligamys je pokazala obetavne rezultate, vendar obstaja veliko pomanjkanje primerjalnih raziskav z rekonstrukcijo, ki bi dale dokončen odgovor o učinkovitosti postopka. Namen: Želeli smo ugotoviti, ali se funkcija kolena po dinamični stabilizaciji strgane sprednje križne vezi po metodi Ligamys razlikuje od funkcije po standardni rekonstrukciji sprednje križne vezi. Metode dela: Opravljena je bila prospektivna raziskava priložnostno vključenih 35 preiskovancev po rekonstrukciji ali dinamični stabilizaciji sprednje križne vezi kolena. Testiranje je potekalo 3 mesece po posegu. Določena je bila stopnja aktivnosti po Tegner lestvici, opravljena Lysholm in IKDC ocena. Opravljene so bile meritve anteriorne laksnosti kolenskega sklepa v položaju za Lachmanov test in v položaju testa prednjega predalčnega fenomena z napravo Rolimeter. Izmerjen je bil obseg aktivne fleksije in ekstenzije kolenskega sklepa z univerzalnim goniometrom. Statistična analiza je bila opravljena s pomočjo programske opreme SPSS in Microsoft Excel. Za primerjavo med skupinama smo uporabili Studentov t-test za neodvisna vzorca, za primerjavo spremenljivke pred in po posegu pa Studentov test za odvisna vzorca. Rezultati: Tri mesece po operativnem posegu med skupinama v stopnji aktivnosti po Tegner lestvici ni bilo statistično značilnih razlik (p = 0,595), prav tako ne v IKDC (p = 0,217) in Lysholm oceni (p = 0,265). Meritve anteriorne laksnosti sprednje križne vezi v položaju 25° in 80° fleksije kolena niso pokazale statistično značilnih razlik med skupinama (p > 0,05). V meritvah aktivne gibljivosti kolenskega sklepa med skupinama ni bilo ugotovljenih statistično pomembnih razlik niti v obsegu fleksije (p = 0,298) niti v obsegu ekstenzije (p = 0,631). Mogoče je, da razlike med skupinama obstajajo, vendar jih zaradi slabe moči testov nismo uspeli dokazati. Razprava in zaključek: Pristop dinamične stabilizacije se je kratkoročno izkazal kot primeren za obravnavo akutne poškodbe sprednje križne vezi ustreznih kandidatov. Zaradi manjše invazivnosti postopka in hkrati krajše odsotnosti z dela je to zagotovo lahko primeren način zdravljenja. Za določitev superiornosti ali vsaj enakovrednosti postopka bo v prihodnje pomembno vključiti več preiskovancev in ugotoviti tudi njegove dolgoročne učinke.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, sprednja križna vez, dinamična stabilizacija Ligamys, rekonstrukcija, funkcija
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Boštjančič]
• Year: 2022
• Number of pages: 34 str., [4] str. pril.
• PID: 20.500.12556/RUL-136103
• UDC: 615.8
• COBISS.SI-ID: 104781571
• Publication date in RUL: 13.04.2022

Secondary language

• Language: English
• Title: Comparison of the knee function after anterior cruciate ligament reconstruction and dynamic stabilization by the Ligamys method : master thesis

Abstract

Introduction: Dynamic intraligamentary stabilisation is a novel technique for treating a ruptured anterior cruciate ligament, developed after shortcomings were observed in the reconstruction method treatment. Ligamys technique has shown promising results but a lack of comparative studies with the reconstruction method exists, which would provide a conclusive answer to the effectiveness of the technique. Purpose: The purpose was to learn whether knee function after the dynamic ligament stabilisation of the anterior cruciate ligament using the Ligamys method differs from knee function after the standard anterior cruciate ligament reconstruction. Methods: A prospective study with 35 random subjects post-reconstruction and post-dynamic intraligamentary stabilisation was conducted. The patients were tested 3 months after the procedure. Patients were assigned the Tegner Activity Scale scores, Lysholm, and IKDC scores. Knee anterior laxity in the Lachman test position and in the anterior drawer phenomenon position was measured with a Rolimeter. Range of active flexion and extension of the knee joint was measured with a universal goniometer. Statistical analysis was conducted with SPSS and Microsoft Excel. The comparison between the two groups was done with Student's t-test for independent samples, the pre-post variable was compared with Student's t-test for paired samples. Results: 3 months post-operation there were no statistically relevant differences between the two groups according to the Tegner Activity Scale scores (p = 0, 595), the IKDC scores (p = 0, 217) and the Lysholm scores (p = 0, 265). Anterior laxity of ACL in 25° and 80° knee flexion did not show any statistically relevant differences between the two groups (p > 0, 05). Measurements of active flexion of the knee joint showed there were no statistically relevant differences in flexion limitation (p = 0, 298) nor in extension limitation (p = 0, 631) in the two groups. Differences between the two groups may exist but could have not been proven due to the low power of the tests. Discussion and conclusion: Short term, dynamic intraligamentary stabilisation proved to be an appropriate approach to treatment of acute ACL injuries in suitable candidates. The procedure is less invasive and means a shorter leave from work, making it an appropriate treatment. Determining the superiority or equivalence of the procedure will need a larger number of subjects and a future examination of its long-term effects.

• Keywords: master's theses, physiotherapy, anterior cruciate ligament, dynamic stabilisation Ligamys, reconstruction, function