FASE 0: Ligamentoplastia rehabilitacion para la operacion del ligamento cruzado anterior

PHASE 0 -    • FASE 0: Ligamentoplastia rehabilitacion pa...   PHASE 1 -    • FASE 1: Ligamentoplastia rehabilitacion pa...   PHASE 2 -    • FASE 2: Ligamentoplastia rehabilitacion pa...   PHASE 3 -    • FASE 3: Ligamentoplastia rehabilitacion pa...   PHASE 4 -    • FASE 4: Ligamentoplastia rehabilitacion pa...   Are you undergoing anterior cruciate ligament reconstruction surgery, or ligamentoplasty? Would you like to learn about the surgical options and what you can do during the first few days? If you're looking for answers to these questions, this video is for you. Hello friends, welcome back to Physiotherapy Within Reach. I'm Marcos Sacristan, and today we're starting a comprehensive series on anterior cruciate ligament reconstruction. We'll analyze the best exercises and recommendations, phase by phase. In this video, I'll explain the two most common surgeries for anterior cruciate ligament reconstruction, as well as the indications for the first three days after surgery. However, if you'd like to access the other phases of rehabilitation, click on the top right corner of the screen. The most commonly used surgeries today are divided into two. The first is called HTH, or bone-tendon-bone, in which the torn ligament is basically replaced with a graft taken from the patellar tendon. It consists of a bone end, H, a patellar tendon body corresponding to the T, and a bone end, H. The bone-tendon-bone graft is inserted in the same location as the injured anterior cruciate ligament and tightened to provide stability to the joint. This type of ligamentoplasty was more commonly used a few years ago; it is still used today, but has given way to a more modern surgical technique called STRI. Which refers to the structures from which the graft is extracted, the semitendinosus and gracilis muscles. Both muscles have a long tendon that ends on the inner lateral side of the knee. Once the tendon is extracted, a graft is created by folding it several times until a graft measuring approximately 7 cm is obtained, which is repositioned in the same location as the injured anterior cruciate ligament. In principle, both techniques are equally effective. In practice, the HTH technique is usually less painful and more rigid, providing greater stability to the knee. However, they are usually more difficult to achieve proper knee flexion. The STRI technique is more painful, less stable in the early stages, and, above all, more fragile. However, in the long term, it has proven to be more effective than the HTH technique. Depending on your medical history and specific characteristics, the surgeon will choose the surgery that best suits your needs. Rehabilitation in both cases is very similar. Whether it's HTH, STRi, or any other type of surgery, the protocol I propose is validated for any type of ligament plasty, as long as you follow your surgeon's instructions. In general, the recovery of the intra-articular graft that replaces the anterior cruciate ligament is slow, very slow. Initially, the graft will be very fragile, and every possible precaution must be taken to protect the knee. The graft will regain its initial strength after 5 to 6 months. Therefore, it is highly recommended that, even if the patient feels well, we pay special attention to dynamic exercises such as jumping, changes of pace, or running. Furthermore, during the first six months, open kinetic chain exercises are strictly discouraged. After this overview, let's see what we can do during the first three days after ligament plasty surgery. The day after surgery, walking with crutches with partial support on the leg is permitted, always keeping the knee fully extended with a hinged or rigid knee brace. Gentle knee mobilization is recommended, between 0 and 30 degrees of flexion, in the company of a physical therapist, without putting any weight on the foot, stopping and always respecting it whenever pain occurs. It is not necessary to achieve either great flexion or great extension during the first few days. Simply induce gentle mobilization to allow drainage of the inflammatory fluid and edema. Applying ice is highly recommended, two or three times a day for 15 minutes, leaving about three hours between each application. Keeping the leg slightly elevated will help improve circulation and combat hematoma and edema. Sleep well and eat well during the first few days; your body will need it. Okay, friends, that's all for the surgical techniques and the first few days of rehabilitation for ACL reconstruction. If you'd like to learn more about rehabilitation in the following phases, you can click on the top right corner of the screen.