| Sažetak | ACL je jedan od ključnih stabilizatora koljena. Ruptura ACL – a je češća kod sportaša i ljudi koji se bave težim fizičkim poslovima. Rupture ACL – a nastaju zbog konstantne napetosti ligamenta u svim pokretima zbog toga što onemogućava međusobne pokrete zglobnih tijela. Faktori rizika koji mogu dovesti do rupture su: povišena tjelesna težina, neadekvatna obuća, mišićni zamor, genetska predispozicija te ženski spol. Ozljede često nastaju zbog izravnog kontakta s drugim igračem (u sportu), naglom promjenom smjera ili nepravilnog doskoka. Sile koje djeluju na zglob su najjače te je to glavni razlog rupture te o toj jačini sila ovisi dali će ruptura biti totalna ili parcijalna. Ruptura ACL – a se dijeli na 3 stupnja: istegnuće, parcijalna ruptura i totalna ruptura. Dijagnoza se postavlja na temelju anamneze, kliničkog pregleda, MR – a te specifičnih testova od koji se primjenjuju Lachmanov test te test prednje ladice. Kod navedenog pacijenta došlo je do rupture ACL – a koja nije odmah sanirana zbog prestanka profesionalnog bavljenja sportom. Nakon otklanjanja ciste pacijent je upućen na fizikalnu terapiju nakon koje mu se stanje poboljšalo. Nakon određenog vremena (6 mjeseci nakon operacije) kod povratka u aktivnost ozljeda se ponovila te je potvrđena sigurna ruptura ACL – a i djelomična ruptura medijalnog meniska. Nakon operacije planirana je detaljna rehabilitacija uz primjenu ortoze. Sama rehabilitacija je podijeljena u 4 faze: rana zaštitna faza, srednja faza, napredna faza te faza povratka u aktivnost. Kroz svaku fazu detaljno je praćen napredak pacijenta kroz manualni mišićni test, mjerenje opsega pokreta kao i mišićni zamor te osjećaj umora. |
| Sažetak (engleski) | The ACL is one of the key stabilizers of the knee. Rupture of the ACL is more common in athletes and people who engage in heavy physical work. ACL ruptures occur due to the constant tension of the ligament in all movements because it prevents mutual movements of the joint bodies. Risk factors that can lead to rupture are: increased body weight, inadequate footwear, muscle fatigue, genetic predisposition and female gender. Injuries often occur due to direct contact with another player (in sports), a sudden change of direction or an improper landing. The forces acting on the joint are the strongest, and this is the main reason for the rupture, and it depends on the strength of the force whether the rupture will be total or partial. ACL rupture is divided into 3 stages: sprain, partial rupture and total rupture. The diagnosis is made on the basis of history, clinical examination, MR - and specific tests, of which the Lachman test and the anterior drawer test are applied. The aforementioned patient had an ACL rupture - which was not repaired immediately due to the cessation of professional sports. After removing the cyst, the patient was sent to physical therapy, after which his condition improved. After a certain time (6 months after surgery) when returning to activities, the injury recurred and a safe rupture of the ACL and a partial rupture of the medial meniscus were confirmed. After the operation, a detailed rehabilitation with the use of orthotics is planned. The rehabilitation itself is divided into 4 phases: early protective phase, middle phase, advanced phase and phase of return to activity. Through each phase, the patient's progress was monitored in detail through a manual muscle test, measurement of range of motion as well as muscle fatigue and feeling of tiredness. |
