CHANGES IN THE FUNCTIONAL STATUS OF THE KNEE IN PATIENTS WITH THE "UNHAPPY TRIAD"

Abstract

The "Unhappy Triad" or "O'Donoghue's Triad" is one of the most severe multiligamentous sports injuries that involves a tear of the ACL, MCL and medial meniscus of the knee. Recovery after surgical treatment is between 6 and 12 months, and many athletes after this injury do not return to their sports activities. Purpose: to follow the functional state of the knee complex in patients after surgical treatment of the "Unhappy Triad", before and after 10 days of kinesitherapy in the moderately protective period. Methodology: 70 patients after surgical treatment of the "Unhappy Triad" were studied, 32 were assigned to a control group (CG) and 38 to an experimental group (EG). In all patients, the treatment of the MCL rupture was conservative (30 days of knee immobilization) with subsequent surgery that included partial meniscectomy and ACL reconstruction using the BPTB method. A traditional model of kinesitherapy was applied in the CG, and in the EG the following were applied: instrumentally assisted soft tissue mobilization - Ergon® IASTM Technique, kinesio tape, post-isometric relaxation, stretching, proprioceptive training, locomotor training, analytical exercises and aquatherapy for 10 days. To monitor changes in the functional state of the knee, a functional scale for complex assessment according to D. Seligson was applied, before and after 10 days of kinesitherapy. Results: the initial average cumulative assessment of the functional state of the damaged knee in CG before kinesitherapy was 4.688, and in EG it was similar – 5.105. The values indicate a severe functional state on the first day of the study. After 10 days of kinesitherapy there was a significant improvement in results in both groups. In absolute values, the functional state of the knee in CG increased by 5.37, and in relative values by 114.67%, in EG it increased by 7.9 or the improvement was by 155.66%. As a result, the final mean cumulative score of patients in the control group was 10.06 and in the experimental group it was 13.05. The testing of the hypotheses for the significance of the differences of the variable in the two groups shows that P>0.05 on the first day of the study, from which it follows that the groups are the same in terms of the studied indicator, and on the tenth day P<0.05, which proves the existence of a statistically significant difference in the average values of the indicator in favor of EG. Conclusions: The applied model of kinesitherapy in the experimental group is more effective and contributes to a more significant complex restoration of the functional state of the knee joint of the patients, compared to the traditional model of kinesitherapy in the control group.