2024年3月1日
Based on the safety and feasibility, this article presents an early weight-bearing rehabilitation protocol after anterior cruciate ligament reconstruction. The protocol is clear and easy to operate, which is helpful to promote its use in clinical practice and accelerate the functional recovery of patients.
Our group conducted a clinical study of early weight-bearing rehabilitation after cruciate ligament reconstruction. The aim of this study is to explore the possibility of implementing the ERAS concept in the early rehabilitation of this disease. We developed a standardized and a deterred early weight-bearing rehabilitation program and observed its feasibility and effectiveness.
There is no concern on the early weight-bearing rehabilitation project after anterior cruciate ligament reconstruction. However, the early weight-bearing rehabilitation can accelerate patients'return to society and improve their satisfaction, which is in line with the contemporary concept of enhanced recovery of surgery. The early weight-bearing rehabilitation program of our team is safe, effective, and feasible.
The program can improve the daily activity or daily allowing and the patient satisfaction. We found no adverse effects of the protocol on the old and the knee stability of the patients. Our findings provide a theoretical basis for accelerated recovery after anterior cruciate ligament reconstruction.
Physical therapist can carry out the early weight-bearing rehabilitation for the patients to improve their self-bearability and reduce dependence and medical costs. After performing anterior cruciate ligament reconstruction, inform the patient about the rehabilitation process. Elevate the affected lower limb to an angle of 30 degrees from the horizontal line.
Place a cold pack on the affected knee for 20 minutes three times daily. When awake, perform ankle pump exercises for five minutes every hour. Have a therapist mobilize the patella in four directions, massage the quadriceps and hamstrings to loosen the patella and surrounding tissue.
Perform isometric contraction training of quadriceps with 10 sets of 10 repetitions daily. Then, extend and flex the knee joint. Instruct the patient to stand with or without a walker, then ask the patients to stand with their feet shoulder width apart.
Have the therapist stand on the affected side of the patient and give them verbal instructions. Observe body posture in a mirror and adjust the posture independently or under the therapist's guidance. Put the affected leg on the electronic body weightometer and gradually increase the weight-bearing intensity of the affected leg to 25%50%75%and 100%of the body weight.
After performing anterior cruciate ligament reconstruction, inform the patient about the rehabilitation process. Ask the patient to stand on their tiptoes and hold for five to 10 seconds. Repeat the action 10 times.
Have the patient stand on the affected lower limb for three to five seconds and repeat 10 times. Position the patient in a neutral stance. Have the therapist and the patient pull on the elastic band in opposite directions for three to five seconds.
Repeat 10 times. Then, place the band around the back of the affected knee and pull forcefully while the patient tries to remain still for five to 10 seconds, repeating 10 times. Direct the patient to face a mirror in a neutral stance.
Instruct the patient to move the healthy foot backward and then forward by one small step without moving the affected foot. Repeat the process 50 times. Guide the patient to move the affected foot backward and then forward by one small step without moving the healthy foot.
Repeat this 50 times. Finally, instruct the patient to walk in a straight line for 10 meters with small steps at a low speed.
本文介绍了一种前交叉韧带重建术后早期负重康复方案。该方案设计清晰且易于实施,旨在促进其在临床实践中的应用,并有助于患者的功能恢复。
前交叉韧带重建术后早期负重康复方案针对肌肉骨骼系统恢复过程中的一个关键转折点,直接影响患者的功能恢复及重返活动的时间进程。标准化、基于证据的康复策略可减少机制上的不确定性,并提高对术后效果预测的可信度。这些方案有助于在骨科治疗领域的转化研究和临床开发中,做出基于风险调整的进展决策。
该康复方案贯穿了从早期发现恢复机制到骨科干预措施的临床前及临床验证的全过程。