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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Trauma causes substantial morbidity and functional impairments among children. The aim of this study was to investigate injuries of children, type of injuries, injury severity, functional impairments and relation between functional impairments and mechanisms of severe injuries in children following trauma in war conditions. This study followed 193 children with trauma, aged 1-16 years, who were admitted and treated in a regional rehabilitation centre from 1992-1995. The degree of injury seriousness was determined according to Injury Severity Scores (ISS). Functional status was measured by means of the own functional assessment scale. Higher ISS was noted for severe injuries caused by firearms than by other means. There was significantly minor functional recovery in children with firearms severe trauma at discharge than with other types of severe injuries (t = 2.04, p < 0.05). The number of all paediatric trauma and firearms injuries decreased by length of war duration. ISS and functional status in children injured by fall at the discharge also decreased. These results show that there are direct and long-term consequences in children age, especially in children with severe traumas caused by firearms, and indicate assessment of psychosocial status of each injured child together with severity of injury.

Pediatric post-traumatic elbow contracture can occur as result of the various injuries of area of the elbow joint. The aim of the study was to investigate the effect of the physical therapy and rehabilitation on the range of the motion of the elbow joint in the post-traumatic elbow contractures in the childhood. We analyzed in this research 54 children (average age 9,4+/-3,15 years) that were treated because of posttraumatic elbow contractures. Kinesitherapy, occupational therapy and other procedures physical therapy are used in the management. Range of the motion of the elbow was measured at the beginning and the end of the therapy for every child. Functional outcome was presented in degree from 1 to 3 (Flynn). Satisfied result of the therapy at the discharge was in the 94, 45% of the children and 74, 07 % of the children had excellent result The difference in the grade at the beginning and the end of the therapy is statistically significant (t= 13,72, p<0,001). Significant improvement of the range of the motion in the elbow joint in the children with post-traumatic elbow contracture is attained by physical therapy.

These results suggest that men with severe osteoarthritis of the hip have better quality of life than do women preoperatively and 6 wks after hip arthroplasty. These findings would be important for improving quality of care of our patients.

Introduction: Tasks of rehabilitation after arthroplasty are to provide painless joint movements, to improve the range of motion, to establish a scheme of walking, to achieve independence in activities of daily living. The aim of the study is to determine the effects of continued rehabilitation on the range of the knee motion and reducing the swelling after total knee replacement. Methods: The study was conducted from 2011 to 2013 and included 140 patients of both sexes, aged 45 to 85 with implanted endoprosthesis based on primary osteoarthritis. They were divided into two groups, experimental, which after early rehabilitation continued ongoing rehabilitation for a period of three weeks, while the control group after completion of early rehabilitation began rehabilitation two months from the surgery for a period of three weeks. The range of motion in the knee joint and the extent of the knee joint in the medium of patella were measured in both groups during the admission and discharge from rehabilitation. In the experimental group, control measurements were carried out three months after surgery. Results: In both groups, there was a significant reduction of the swelling at the discharge in relation to the admission while in the experimental group there was no change on the control of the joint swelling after three months in relation to the release from rehabilitation. In the experimental group, the range of motion of flexion and extension was improved at the discharge in relation to the admission as well as the flexion during the control while the range of motion of extension wasn't significantly changing during the control examination. In the control group, the extension and flexion were significantly improved at the discharge compared to the admission. Comparing both groups, the results showed that there was a significant improvement in flexion movements in the experimental group during rehabilitation in comparison to the control group, while the range of motion of the extension was not significantly different in these two groups. Comparing the range of motion of the experimental group on the control examination and the control group at discharge, it is demonstrated significant improvement in flexion and extension in the experimental group. Conclusion: Results of monitoring the reduction of the swelling and the return of the range of motion confirm the advantage of continuous rehabilitation.

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Coservative treatment consists of rest, physical therapy, pharmacological therapy and injection therapy. Physical rehabilitation with active patient participation is a key approach to treatment of patients with discogenic pain. Physical therapy, occupational therapy and kinesitherapy are important for improving muscle strength, endurance, and flexibility. Disc surgery is performed if surgical intervention is required.