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2018, vol. 75, br. 3, str. 281-289
Dijagnostika i operativno lečenje zadnje nestabilnosti kolena
aUniverzitet u Beogradu, Medicinski fakultet, Institut za ortopedsko-hirurške bolesti 'Banjica' + Univerzitet u Beogradu, Medicinski fakultet
bKlinički centar Kragujevac, Klinika za ortopediju i traumatologiju + Univerzitet u Kragujevcu, Medicinski fakultet

e-adresamiodrag.glisic@gmail.com
Sažetak
Uvod/Cilj. Zadnji ukršteni ligament je primarni stabilizator zadnje translacije tibije i sekundarni stabilizator spoljašnje rotacije tibije kao i varus, valgus angulacije u kolenu. To je najjača ligamentarna struktura u kolenu koja se najređe povređuje. Cilj ovog rada bio je da se prikažu indikacije za operaciju, operativna tehnika i rezultat operativnog lečenja zadnje nestabilnosti kolena. Metode. Studijom je bilo obuhvaćeno 12 pacijenata operativno lečenih zbog zadnje nestabilnosti kolena na Institutu za ortopedsko-hiruške bolesti 'Banjica', Beograd, u periodu od 1.1.2010. do 1.1.2014. godine. Kod svih pacijenata rađena je artroskopski asistirana anatomska rekonstrukcija zadnjeg ukrštenog ligamenta četvorostrukim graftom tetiva hamstrings-a. Prosečno postoperativno prać enje bilo je 42 meseca (24-60) a upoređivane su vrednosti Lysholm i International Knee Documentation Committee (IKDC) skora, kao i klinički status. Rezultati. Svi operisani pacijenti imali su III stepen zadnje nestabilnosti. Udružene povrede posterolateralnog ugla i prednje ukrštene veze bile su česte - 75%. Srednja vrednost Lysholm skora preoperativno bila je 45,92, a postoperativno 85,92, što je statistički značajno poboljšanje, slično kao i vrednost subjektivnog IKDC skora čija je preoperativna srednja vrednost bila 38,58, a nakon operacije i rehabilitacije 89,75. Klinički pregled je pokazao bolju zadnju stabilnost kolena, mada je kod 50% pacijenata ostao određeni stepen nestabilnosti. Zaključak. Artroskopska rekonstrukcija četvorostrukom tetivom hamstrings-a daje zadovoljavajući rezultat kod rekonstrukcije zadnje ukrštene veze. Subjektivni osećaj pacijenata bolji je nego objektivan klinički nalaz. Mada je sama operacija tehnički zahtevna, kod fizički aktivnih pacijenata sa III stepenom zadnje nestabilnosti ona daje bolji rezultat od neoperativnog lečenja.
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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
DOI: 10.2298/VSP160615344G
objavljen u SCIndeksu: 31.05.2018.
metod recenzije: dvostruko anoniman
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