Abstract | Cilj rada je prikazati biomehaničke parametre hoda snimljene 6 mjeseci nakon ACLR-a na profesionalnoj rukometašici te na temelju tih podataka predložiti moguće smjernice u korekciji tih parametara. Ovaj rad se sastoji od dva dijela: teoretski dio i istraživački dio – prikaz slučaja. U prvom dijelu prikazane su: faze hoda, biomehanika lokomotornog sustava čovjeka, anatomija koljena, biomehanika koljena, anatomija ACL-a, biomehanika ACL-a, mehanizmi nastanka ozljede ACL-a, epidemiologija, operativni i konzervativni pristup liječenju i na koji način se može raditi rekonstrukcija ACL-a. Koljeno je kompleksan zglob sa puno mekih struktura unutar i oko zgloba. Najčešća ozljeda u koljenu je ozljeda ACL-a. Četiri su najčešća mehanizma nastanka ozljede: mehanizam nagle deceleracije, mehanizam iznenadne i jake hiperekstenzije, mehanizam iznenadne i jake promjene smjera, mehanizam doskoka na puno i fiksirano stopalo. Žene imaju veći rizik od rupture ACL-a. Liječenju se može pristupiti operativno i konzervativno. Sportaši najčešće biraju operativno liječenje jer se žele vratiti bavljenju sportom. ACL se sastoji od tri snopa – anteromedijalni, posterolateralni i intermedijalni. Hvatište na femuru se nalazi na posteromedijalnom dijelu lateralnog kondila, a hvatište na tibii se nalazi između lateralnog i medijalnog kondila, ali s anteriorne strane interkodilarne jame. Glavne zadaće ACL-a su: priječi anteriornu translaciju tibie, unutarnju rotaciju tibie i valgus poziciju koljena. U radu je prikazan jedan slučaj ACLR-a. Promatrani i analizirani su kinematika i EMG hoda 6 mjeseci nakon operacije. Utvrđene su asimetrije na temelju kojih smo donijeli određene zaključke o samoj rehabilitaciji. Biomehanička analiza hoda je svakako preporučljiva za bolje i kvalitetnije praćenje razvoja rehabilitacije i u konačnici za što raniji i sigurniji povratak sportu. |
Abstract (english) | The aim of the paper is to present the biomechanical gait parameters recorded 6 months after ACLR on a professional handball player and, based on these data, to propose possible guidelines for the correction of these parameters. This work consists of two parts: a theoretical part and a research part - a case report. The first part presents: phases of walking, biomechanics of the human locomotor system, anatomy of the knee, biomechanics of the knee, anatomy of the ACL, biomechanics of the ACL, mechanisms of ACL injury, epidemiology, operative and conservative approach to treatment and how it can do ACL reconstruction. The knee is a complex joint with many soft structures inside and around the joint. The most common knee injury is an ACL injury. There are four most common mechanisms of injury: mechanism of sudden deceleration, mechanism of sudden and strong hyperextension, mechanism of sudden and strong change of direction, mechanism of landing on full and fixed foot. Women have a higher risk of ACL rupture. The treatment can be approached operatively and conservatively. Athletes most often choose operative treatment because they want to return to playing sports. The ACL consists of three bundles – anteromedial, posterolateral and intermediate. The grip on the femur is located on the posteromedial part of the lateral condyle, and the grip on the tibia is located between the lateral and medial condyles, but on the anterior side of the intercodylar fossa. The main tasks of the ACL are: prevention of anterior translation of the tibia, internal rotation of the tibia and valgus position of the knee. In the paper, one case of ACLR is presented. Gait kinematics and EMG were observed and analyzed 6 months after surgery. Asymmetries were identified, on the basis of which we reached certain conclusions about the rehabilitation itself. Biomechanical analysis of gait is certainly recommended (for better and better monitoring; for better monitoring) of the development of rehabilitation and ultimately for an earlier and safer return to sports. |