| Sažetak | Cilj rada je prikazati fizioterapijski proces koji se primjenjuje nakon artroskopske rekonstrukcije medijalnog patelofemoralnog ligamenta (MPFL-a). MPFL je glavni pasivni medijalni stabilizator patele i odgovoran je za 60 do 80% stabilnosti patele. Akutnom primarnom luksacijom koljena dolazi do njegovog oštećenja u čak 90% slučajeva. Nakon što jednom dođe do njegove ozljede, kasnije postaje vrlo teško povratiti njegovu prvobitnu funkciju. Artroskopska rekonstrukcija MPFL-a nametnula se kao provjerena metoda, gdje se fiksiranjem presatka na mjesto ozlijeđenog MPFL-a vraća funkcija i potrebna stabilnost pateli. Nakon operacije slijedi dugotrajna rehabilitacija koja počinje prvi dan postoperativno. Procjenom pacijenta počinje fizioterapijski proces nakon kojeg slijedi rehabilitacija. U ranoj fazi rehabilitacije cilj je kontrola boli, smanjenje edema i upale te sprečavanje kontraktura zgloba. U toj fazi primjenjuju se fizikalne procedure i kreće se s pasivnim i aktivnim terapijskim vježbama opsega pokreta te jačanja muskulature potkoljenice i natkoljenice uz kontinuirani napredak. Daljnjim napretkom uvode se vježbe propriocepcije i ravnoteže koje imaju važnu ulogu u procesu rehabilitacije. U zadnjoj fazi uvode se vježbe agilnosti, snage i brzine koje postepeno razvijaju mišićnu snagu i izdržljivost kod pacijenta. Kontinuirano se povećavaju intenzitet i frekvencija treninga te se pacijenta priprema za nadolazeće funkcionalne aktivnosti. Fizioterapijski proces pokazao se kao učinkovit alat u pripremi sportaša za povratak na sportske terene, iako određeni dio nikada ne dostigne svoju preoperativnu razinu, veliki postotak njih se uspio vratiti sportskim aktivnostima. |
| Sažetak (engleski) | The aim of the work is to present the physiotherapy process applied after arthroscopic reconstruction of the medial patellofemoral ligament (MPFL). The MPFL is the main passive medial stabilizer of the patella and is responsible for 60 to 80% of the patellar stability. Acute primary luxation of the knee causes its damage in 90% of cases. Once its injury occurs, it becomes very difficult to restore its original function. Arthroscopic reconstruction of the MPFL has become established as a proven method, where the function and necessary stability of the patella are restored by fixing the graft at the site of the injured MPFL. The surgery is followed by long-term rehabilitation, which begins on the first postoperative day. The physiotherapy process begins with the assessment of the patient, followed by rehabilitation. In the early phase of rehabilitation, the goal is to control pain, reduce edema, inflammation and prevent joint contractures. In this phase, physical procedures are applied as well as with passive and active therapeutic exercises for the range of motion and strengthening of the musculature of the lower leg and upper leg are carried out with continuous progress. With further progress, proprioception and balance exercises are introduced, which play an important role in the rehabilitation process. In the last phase, agility, strength, and speed exercises are introduced, which gradually develop muscle strength and endurance in the patient. the intensity and frequency of training are continuously increased and the patient is prepared for upcoming functional activities. The physiotherapy process has proven to be an effective tool in preparing athletes to return to sports fields, although a certain part never reaches their preoperative level, a large percentage of them managed to return to sports activities |
