Rehabilitation Following a Minimally Invasive Procedure for the Repair of a Combined Anterior Cruciate and Posterior Cruciate Ligament Partial Rupture in a 15-Year-Old Athlete

Abstract

response to facilitate healing. 3,5,34 Murray et al 34 examined the histological changes seen in 23 ruptured anterior cruciate ligaments (ACLs) and found that the healing ligament forms a layer of synovial tissue over its ruptured surface that may impede repair and result in ligament retraction. Of note, none of the ACLs in this study demonstrated tissue bridging between the ruptured tibial and femoral remnants. Studies comparing the intrinsic properties of the injured ACL and medial collateral ligament reveal that fibroblasts of the ACL demonstrate lower proliferation, lower migration potential, and lower response to growth factors. 36,48,55 Likewise, fibroblasts within cruciate ligaments synthesize nitric oxide, a free radical that has been shown to inhibit synthesis of both collagen and proteoglycan in larger amounts when compared to cells of the medial collateral ligament.10 Collectively, these results indicate a lower overall healing potential for the cruciate ligaments.Articular cartilage has similar difficulties in healing potential and exhibits limited potential for repair due to its avascular nature and the inability of chondrocytes to mount a sufficient T he poor healing potential of injured cruciate ligaments has been well documented. 4,5,9,26,45 Failure to completely heal is thought to be due to inhibitory effects of the intra-articular environment, such as a lack of cytokine stimulation and poor hematoma formation. 3,5,34 In addition, the cruciate ligaments appear to have an inherent inability to produce a significant t sTuDy DEsign: Case report.t BaCKgrounD: The healing response procedure is a minimally invasive arthroscopic surgical technique used to stimulate healing in the treatment of partial cruciate ligament tears. The purpose of this report is to provide information on the surgical procedure, the postoperative rehabilitation, and the overall functional results in a patient who underwent such a procedure.t CasE DEsCriPTion: A 15-year-old male, who sustained a partial tear of both the anterior cruciate and posterior cruciate ligament while playing football, underwent arthroscopic surgical management utilizing a healing response technique. Precautions concerning range of motion and resisted activities were followed postoperatively to protect the healing cruciate ligaments. The postoperative protocol consisted of 3 phases, culminating in return-to-sport training. Treatment incorporated cardiovascular, proprioceptive, strength, power, plyometric, and sport-specific activities. Treatment was progressed based on specific criteria emphasizing proper movement patterns and eccentric control during functional activities.

Posterior cruciate ligament rupture and all-epiphyseal repair with suture tape augmentation in a 5-year-old girl: a case report and review of the literature

“…These issues must also be addressed during preoperative consultation regarding the risks and benefits of the procedure. Meanwhile, quadriceps strengthening during recovery and rehabilitation remains crucial in this case [ 21 ].…”

Traqueostomia: Atuação Fisioterapêutica Na Decanulação

“…De acordo com o estudo de Angelozzi et al., (2012), a restauração de estabilidade ligamentar, de força muscular máxima, controle neuromuscular, pode influenciar na segurança para realização da prática esportiva após a reconstrução do LCA. Outro treinamento importante referese aos de potência muscular com exercícios pliométricos que devem ser incluído nas abordagens pós-cirúrgicas e sua medição deve ser realizada para avaliar a recuperação total antes do reinício de atividades esportivas (BEECHER et al, 2010).…”