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Return to sport after ACL reconstruction of the anterior knee ligament (ACL)

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Return to sport after ACL reconstruction of the anterior knee ligament

What sport are we talking about?. In effect resumption of sport is a generic term that encompasses businesses that lives and cardiovascular, an activity of a well pivots sports activities in competition.

We talk of return to sport or to pre-injury or to pre-surgery or even be the maximum possible level of the knee recovery. For example, the recovery of a knee that has been unstable for several years with meniscal and cartilage damage could not be the same without a knee cartilage injuries of the meniscus operated in a quick time after the breakup.

There are different levels of resumption of athletic activity. These steps follow one another in a single sequence, variable depending on the patient, the knee is the type of ligament.

The first is cardiovascular activity, feasible gym. We can go cycling, rowing, physical preparation of the upper body, strengthen the lower limb.

Second level of activity: the racing activities which are set very gradually by intensity levels. We must begin with a plot with sequences of short duration. Gradually increasing the length, vertical drop is the necessary aerobic expense.

Finally, the pivot activities which expose the knee to torsional stresses. Once validated the previous two types of activity are undertaken. First guided by the reduced by the physiotherapist, then carried on outside ground, and then taken up with other interactions. That is to say initially the knee is completely controlled by the patient, then subjected to controlled external events and completely random, to progressively achieve the disappearance of apprehension of sensations.

Three factors determine the patient's ability to resume his sporting activity.

The first element: the anatomical healing: the ligament has achieved good control of laxity on the eve Liga ventilation ligament is obtained, it is able to undergo further stretching pulling phenomena and bring knees and feeling of comfort in the exercises and strength. Evaluating it with the clinical examination of the surgeon, the measurement of laxity (such GNRB bone).

Second element: the physical and functional recovery of the knee. recovery mobilities of muscle strength of the muscular power of the patient's sensation of pulse stability and power. This is achieved through rehabilitation. We carry a muscle control with ISO kinetic evaluation, a test sound on one foot, and the visual sensation of symmetry to the running and jumping both knees. This step is validated by the rehabilitator. We also perform a psychological evaluation of the patient's recovery, the disappearance of apprehensions of return of confidence in him and in his knee. These psychological elements arepredominant over all other elements muscle, ligament, rehabilitative, anatomical. Indeed, the physical resilience is not correlated with psychological capacities. With identical anatomical lesions, patients will be occasions sports activities in time and to totally different levels. We use a validated score by an Australian team in Melbourne, called ACL-Rsi. This score indicates the psychological recovery level. Below 80% rating have not resumed their sport. Beyond 80% they resumed their sport. That is not a recovery criterion is an independent objective element of the other factors of monitoring.

Third element: the competition is determined by the recovery coaches fitness coach, is the technical supervision which determines whether or not the player's ability is applied once the first two steps perfectly validated.

Doctor Yoann BOHU, Doctor Nicolas LEFEVRE, Doctor Serge HERMAN. - 30 décembre 2015.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.


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