By Dr. Francesco Cundo "
ANTERIOR CRUCIAL LIGAMENT
The tibial insertion is located on the pre-spinal surface between the anterior horn insertion of the internal meniscus forward and that of the external meniscus back.
Its path is oblique up, back and out.
The femoral insertion is located on the axial face of the external condyle.
INJURY OF THE ANTERIOR CRUCIAL LIGAMENT
The most common mechanism is a non-contact twisting motion in which the foot remains fixed on the ground as the athlete tries to change direction, causing deceleration, valgus stress and internal rotation.
RECONSTRUCTION OF THE L.C.A. WITH SELF-TRANSPLANTATION OF THE THIRD MEDIUM OF THE ROTULA TENDON.
This technique uses part of the patellar tendon, the middle third, with the bone bracts of the tibia and patella that are screwed into the bony tunnels in the tibia and femur.
The advantages of this method are the tightness given by the patellar tendon and, therefore, the stability of the knee;
The weak points are related to the interference caused to the extensor apparatus with the removal of part of the patellar tendon.
FUNCTIONAL RECOVERY PROGRAM
Mobilization
Load within the limits tolerated by the subject;
Early closed kinetic chain exercises for strengthening and neuromuscular control.
KINETIC CHAIN EXERCISES CLOSED
Greater joint compression forces;
Reduction of transverse cutting forces;
Reduction of acceleration forces;
Stimulation of proprioceptors;
Simultaneous contraction of the agonist and antagonist muscles;
Increased dynamic stability;
Safer.
Increased acceleration forces;
Increased distraction and rotation forces;
Presence of forces that cause concentric accelerations and eccentric decelerations;
Decreased stability;
Usually limited to a single joint;
More dangerous for soft structures in the process of healing.
KINETIC CHAIN EXERCISES OPEN
Increased acceleration forces;
Increased distraction and rotation forces;
Presence of forces that cause concentric accelerations and eccentric decelerations;
Decreased stability;
Usually limited to a single joint;
More dangerous for soft structures in the process of healing.
USABLE MACHINES
LEG PRESS
offers all the advantages of a closed kinetic chain;
Guarantees good stability;
It allows the execution of exercises with a load lower than the weight
body and to exercise one leg at a time.LEG EXTENSION
LEG CURL
RUN
BIKE
HOW TO ACT AFTER AN APPROPRIATE PHYSIOTHERAPY PROGRAM
THE INITIAL FUNCTIONAL REHABILITATION INCLUDES:
Bipodal mini squats
Isometric contractions
Bipodalic leg press
Bike from 5 to 10 minutes
Seated proprioceptivity with large and small balls
Passive bending to the wall 0 ° -100 °
ONLY IN A SUBSEQUENT PHASE
Walking with eyes closed
Walk uphill on RUN
Proprioceptive tablet
0 ° -30 ° monopodalic squats (3x10)
Isometric contractions
Upright monopodalic postures with closed eyes
Pyramidal monopodalic leg press
Leg curl
Stretching (PNF)
AFTER ABOUT 2 MONTHS
Single leg leg press
Jump rope
Run on the spot, in a circle, kicked
Leg extension 90 ° -30 °
ONLY AFTER 4 MONTHS
Increase of loads on all isotonic machines
Complete leg extension
Maximum stroke
Maximum jump
Athletic routes
