Introduction:Numerous rehab protocols have been used in rehabilitation after ACL reconstruction. Isokinetic testing is an objective way to evaluate dynamic stability of the knee joint that estimates the quality of rehabilitation outcome after ACL reconstruction. Our investigation goal was to show importance of isokinetic testing in evaluation thigh muscle strength in patients which underwent ACL reconstruction and rehabilitation protocol.Subjects and methods:In prospective study, we evaluated 40 subjects which were divided into two groups. Experimental group consisted of 20 recreational males which underwent ACL reconstruction with hamstring tendon and rehabilitation protocol 6 months before isokinetic testing. Control group (20 subjects) consisted of healthy recreational males. In all subjects knee muscle testing was performed on a Biodex System 4 Pro isokinetic dynamo-meter et velocities of 60°/s and 180°/s. We followed average peak torque to body weight (PT/BW) and classic H/Q ratio. In statistical analysis Student’s T test was used.Results:There were statistically significant differences between groups in all evaluated parameters except of the mean value of PT/BW of the quadriceps et velocity of 60°/s (p>0.05).Conclusion:Isokinetic testing of dynamic stabilizers of the knee is need in diagnostic and treatment thigh muscle imbalance. We believe that isokinetic testing is an objective parameter for return to sport activities after ACL reconstruction.

Introduction:The use of rehabilitation protocol which corresponds to surgical technique results in optimal postoperative outcome and functional recovery of patients to a pre-injury level of activity. The aim of this paper is to show the effects of the official rehabilitation protocol in our Institute on functional recovery of patients after anterior cruciate ligament (ACL) reconstruction.Patients and methods:In prospective study, we evaluated 70 males after ACL reconstruction using hamstring graft. Patients were divided into two groups according to the manner of conducting the postoperative rehabilitation. Group A consisted of 35 patients that followed postoperative rehabilitation according to the rehabilitation protocol. Group B also 35 patients, which did not undergo the rehabilitation protocol. We evaluated thigh muscle circumference and modified Tegner Lysholm Score, preoperatively and postoperatively after 1,3,6 and 12 months. In the statistical analysis, the Studentov T-test was used.Results:In the first postoperative month, the difference between groups in thigh muscle circumference is statistically significant (p<0,05). This difference between groups is statistically highly significant after 3, 6, and 12 months postoperative (p<0,01). Results of the modified Tegner Lysholm Score is statistically highly significant in 1, 3 and 6 postoperative months in patients from the experimental group (p<0,01).Conclusion:The positive effects of the rehabilitation protocol results in significant increase of the thigh muscle circumference and faster functional recovery of patients after ACL reconstruction.

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UvodKongenitalna radioulnarna sinostoza predstavlja anomaliju uzdužne segmentacije radijusa i ulne. Gornji ekstremitet se razvija od 26. do 46. dana embrionalnog razvoja kada dolazi do segmentacije na radijus i ulnu. Abnormalnosti razvoja i teratogeni faktori, u ovom periodu, mogu da dovedu radioulnarne sinostoze [1][2][3][4][5][6].Anomalija je rijetka, u 60% slučajeva obostrana, jednake polne distribucije. Može biti udružena sa razvojnim poremećajem kuka, pes equinovarus, nedostatkom palca, dislokacijom radijusa, te Klinefelterovim sindromom, Nievergelt-Pearlmanovim sindromom ili sa akrocefalosindaktilijom [2][3][4][5].Radioulnarna sinostoza se klinički manifestuje u starosti od oko dvije i pol godine funkcionalnim poteškoćama. Otežano je držanje malih predmeta što se vidi kod hranjenja, oblačenja i sportova koji zahtijevaju upotrebu ruku. Skraćena je podlaktica. Moguća je fleksiona kontraktura od 16 stepeni, a fiksirana pronacija od 15 do 150 stepeni. Postoji hipermobilnost ručnog zgloba [1,2].Radiološki se radioulnarna sinostoza manifestuje širokim dijapazonom anatomskih varijacija od fibrozne sinostoze do potpune koštane, fiksirane sinostoze. Može se uočiti odsustvo deformiteta i dislokacija glave radijusa [6].Originalna klasifikacija prepoznaje 2 tipa [1]: -proksimalna ili prava radioulnarna sinostoza (radijus i ulna spojeni proksimalnim granicama različite dužine), i -radioulnarna sinostoza sa kongenitalnom dislokacijom glave radijusa (fuzija distalno od proksimalne epifize radijusa).Modifikovana klasifikacija poznaje 4 tipa [2]: -tip I (sinostoza ne zahvata kost, a udružena je sa redukovanom glavom radijusa), -tip II (vidljiva koštana sinostoza sa urednom glavicom radijusa), -tip III (vidljiva koštana sinostoza sa hipoplastičnom ili zadnjom luksacijom glave radijusa),