No abstract

Background. In modern medical practice, a significant interest in the study of quality of life is manifested in the biopsychosocial approach, which indicates the concept of a holistic view of the course of the disease and the effectiveness of treatment. Aim. To give a comparative assessment of the quality of life and the effectiveness of treatment of patients after early and delayed reconstruction of an isolated injury of the anterior cruciate ligament. Material and methods. The results of a survey of 782 patients aged 1854 years according to the international standardized questionnaire of the quality of life (SF-36 Short Form-36 Health Survey Questionnaire) before and after arthroscopic reconstruction of an isolated injury of the anterior cruciate ligament using a free autograft from the tendons of the semitendinosus and tender muscles are presented. All patients were divided into two groups. The first group included 403 patients (232 males and 171 females), anterior cruciate ligament plasty was performed at an early stage, from the 1st to the 6th week after the injury. The second group included 379 patients (211 males and 168 females) who were operated on late, from the 7th week to 1 year after the injury. Statistical analysis was performed using the Statistica 12.0 program (Stat Soft, Inc.). The significance of differences between independent samples was determined using nonparametric tests: the MannWhitney U test and the Wilcoxon T test. Results. It was found that 1 year after the operation, in patients of the first group, the values of the treatment effectiveness indicator in terms of the total indicator of physical and mental components of health are significantly higher compared to the second group (p 0.0001, MannWhitney U-test). A high correlation between the indicators of treatment effectiveness according to the assessment scales of the physical component of health and the mental component of health in groups depending on the timing of the reconstruction of the anterior cruciate ligament was found. Thus, the Spearman's rank correlation coefficient in the first group between the indicators of treatment effectiveness in terms of the total indicator of the physical and mental components of health was r=0.79 (p=0.001), and in the second group r=0.71 (p=0.001). Conclusion. The long-term results of assessing the quality of life of patients indicate the predominant effectiveness of the treatment of patients operated on in the early stages after injury, compared with delayed surgery.

The aim of this study was to study the effectiveness of complex individual physical rehabilitation in patients after arthroscopic anterior cruciate ligament reconstruction. Material and methods. The study involved 834 patients (464 men and 370 women) aged 18-55 years with an isolated rupture of the ACL of the knee joint. The patients were divided into two groups: the main group - 304 patients (162 men and 142 women), in which rehabilitation treatment and complex rehabilitation were carried out according to an individual program, and the control group - 530 patients (302 men and 228 women), in which patients received only rehabilitation treatment after ACL reconstruction. Results. The research revealed that 1 year after ACL arthroscopic reconstruction and physical rehabilitation in patients of the main group, higher values of median efficiency according to orthopedic questionnaires were established than in the control group (p<0.0001, Mann-Whitney U-test). The use of complex physical rehabilitation after ACL arthroscopic reconstruction provides a higher recovery of physical activity and an increase in the quality of life of this category of patients.

Background. Anterior cruciate ligament rupture is the most common knee joint injury, especially in young people with a healthy and active lifestyle. The concept of quality of life has been dynamically developing. The scope of its application is expanding in various fields of medicine to provide a comprehensive assessment of treatment and rehabilitation efficacy.Objective — to assess the feasibility of complex individual physical rehabilitation of patients after early and delayed arthroscopic reconstruction of the anterior cruciate ligament (ACL).Methods. Open simple non-randomized trial enrolled 834 patients with the anterior cruciate ligament rupture of the knee joint. In the first group (431 patients), ACL plastic surgery was performed in the early stages — between weeks 2 and 6. In the second group (403 patients), ACL reconstruction was performed in the later stages — from week 7 to 1 year, inclusive. Each group was divided into two subgroups — the main one, in which restorative treatment and comprehensive individual rehabilitation were carried out, and the control group, with rehabilitation treatment in accordance with the standards of postoperative treatment. The study was conducted in Traumatology, Orthopedics and Medical Rehabilitation Unit of Clinical Hospital No. 1. Patients were included in the trial from 2016 to 2021. The follow-up period for each patient was one year. Statistical data processing was performed by means of Statistica 12.0 (StatSoft, Inc., USA). Independent samples were compared using non-parametric criteria: Mann — Whitney U-test and Wilcoxon T-test.Results. No statistical differences were found in the distribution according to gender, age and body mass index. A comparative analysis of scale medians of Medical Outcomes Study 36Item Short-Form Health Survey (MOSSF-36), conducted in patients before surgery, revealed no statistically significant differences ( p>0.05) between the main and control subgroups in both groups. Analyzing medians before ACL reconstruction showed a significant decrease in comparison with population studies ( p < 0.0001, Mann — Whitney U-test). The analysis of physical and mental component summaries via MOSSF-36 revealed statistically significant differences in the effectiveness of treatment of patients in 1 year after ACL plastic surgery and complex individual rehabilitation. Thus, in the main subgroups, the values of treatment efficacy medians were significantly higher than in the control ones, regardless of the timing of ACL plastic surgery ( p < 0.001, Mann — Whitney U-test). The results testify to higher median efficacy values in patients of the main subgroup of group 1 than in other subgroups ( p < 0.001, Mann — Whitney U-test). The study of correlative relationships demonstrated a stronger relationship between the medians of physical and mental component summaries in the main subgroup of the first group (correlation coefficient = 0.76), if compared to the main subgroup of the second group (coefficient = 0.67).Conclusion. The study testified to the treatment efficacy proved using the scales of physical and mental component summaries. They demonstrated more significant treatment efficacy one year after arthroscopic ACL reconstruction and individual rehabilitation in the main subgroup of group 1 than in the other subgroups.