title: [Biomechanical principles of after-care in replacement of the anterior cruciate ligament].
abstract: The patellar tendon graft replacing the anterior cruciate ligament undergoes histomorphological and biomechanical changes. From literature we can estimate a force of 200 N to be a critical limit of graft load after ACL-plasty in humans. The comparison with the graft loads under various conditions provided the following conclusions: Unlimited passive motion of the knee joint can be done without risk. Early weight bearing is possible. Active extension exercise against gravity could damage the graft in the range of 0 to 20 degrees of flexion in some patients. A rehabilitation protocol has to regard these biomechanical principles. In a prospective study 74 patients underwent rehabilitation according to the protocol described. An extension contracture of more than 10 degrees was seen in 9 patients. In all cases it was due to a notch-impingement or a cyclops. One year after operation 57 patients had a follow up. The side to side-difference in anterior drawer measured with a KT-1000-arthrometer was less than 2 mm in 45 patients. Six patients had difference between 2 and 4 mm. In six patients the difference was more than 4 mm.
authors.affiliation: Orthopädische Universitätsklinik, Homburg/Saar.
authors.forename: S
authors.initials: S
authors.lastname: Rupp
authors.forename: T
authors.initials: T
authors.lastname: Hopf
authors.forename: M
authors.initials: M
authors.lastname: Gleitz
authors.forename: T
authors.initials: T
authors.lastname: Hess
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive; D017847:Patellar Ligament / Q000503:physiopathology / Q000637:transplantation*; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D011183:Postoperative Complications / Q000503:physiopathology / Q000534:rehabilitation*; D016474:Weight-Bearing / Q000502:physiology
vernacular_title: Biomechanische Grundlagen der Nachbehandlung der Ersatzplastik des vorderen Kreuzbandes.