Substantiation of the application of osteopathic correction in the complex rehabilitation of patients after anterior cruciate ligament reconstruction surgery
Authors: Vorobyev S. V. , Dolinina O. Yu. , Mokhov A. D. , Miroshnichenko D. B. 
Published: March 2023

Introduction. For a qualitative restoration of the knee joint function after arthroscopic reconstruction of the anterior cruciate ligament, the process of engraftment, restoration of the strength and viability of the graft (new anterior cruciate ligament) is important. The weakening of the inflammatory process after surgery and the return of strength and tone to the muscles that ensure the proper functioning of the injured knee joint are equally important. Restoring the properties of the damaged fascia, providing proprioceptive control of the periarticular muscles for the stability of the knee joint are the priorities of the rehabilitation process. Somatic dysfunctions that have been previously presented, as well as have appeared at the time of injury or during surgery, slow down recovery. Therefore, the inclusion of osteopathic treatment in the rehabilitation process seems to be a logical step. However, the problem of the osteopathic correction role in the rehabilitation process in case of the anterior cruciate ligament damage has been covered very little in the specialized literature.

The aim of the study is to substantiate the use of osteopathic correction in the complex rehabilitation of patients after anterior cruciate ligament reconstruction surgery.

Materials and methods. The study involved 47 patients who underwent arthroscopic knee surgery for reconstruction of the anterior cruciate ligament. 23 patients who underwent the recommended rehabilitation course were included in the control group, 24 patients who additionally received a course of osteopathic correction were included in the main group. Before and after the treatment, there were assessed osteopathic status of patients, the range of movements in the operated knee joint, the dynamics of the inflammatory process (according to such indicators as changes in the local temperature of the knee joint and the thermal symmetry, as well as the circumference of the knee joint), and the pain intensity.

Results. At the beginning of the study, regional somatic dysfunctions of the lower limb region were most often detected in main and control groups (100 and 65,2 %, respectively) and the pelvic region (91,7 and 87 %, respectively). After the treatment, statistically significant (p<0,05) positive dynamics was observed in the main group in terms of such indicators as the detection frequency of regional dysfunctions of the lower extremities, pelvis, neck and thoracic region. There was no significant dynamics in the control group. In both groups, there was a significant (p<0,05) positive dynamics in such indicators as the range of movements in the joint, local temperature and thermal symmetry, joint circumference, pain intensity. A statistically significantly (p<0,05) more pronounced result was observed in the main group than in the control group for all the listed indicators.

Conclusion. The study confirms the positive contribution of osteopathic correction to expanding the possibilities of complex rehabilitation of patients after arthroscopic anterior cruciate ligament plasty. However, it is recommended to continue research in this direction on a larger sample size.