Goede resultaten van vroegtijdige mobilisatie na voorste-kruisbandreconstructie

Evaluation of the results of early mobilisation after intra-articular reconstruction of the anterior cruciate ligament.

Setting

Leyenburg Hospital, The Hague, Netherlands.

Design

Prospective study.

Method

An autologous graft of 50-60 of the patellar tendon (mid portion) was used for anterior cruciate ligament reconstruction in 50 patients (19 females, 31 males, average age 26 years). A rehabilitation programme with immediate weightbearing postoperatively without any external protection was applied. Evaluation, consisting of function and stability tests, Tegner activity level, Lysholm's function score and the subjective result, was performed 26.2 months on average after reconstruction.

Results

The stability, tested manually with the KT-1000 arthrometer, was good in 45 of 50 patients, 5 had a positive pivot shift test. Only 2 patients complained of the knee giving way. In 32 of the 35 first patients no change in stability was found during observation after 1, 6, 12 and 24 months. All 50 patients regained good knee function. The result was described as ‘good’ in 40 of 50 patients, ‘fair’ in 7 and ‘poor’ in 3. Five of these latter 10 patients objectively had good stability of the knee. The mean time to resume activities was 5.4 weeks for full weightbearing, 10 weeks for running, 13.5 weeks for going back to work and 6 months for returning to previous sports. No patellar ruptures were seen.

Conclusion

The operation used in this study and early mobilisation appear to give early knee rehabilitation without morbidity and with good stability.