Comprehensive rehabilitation for injuries to the medial collateral ligament of the knee in skiers and snowkiters
- Authors: Levkov V.Y.1, Ikonnikova M.S.1, Andronova L.B.1, Remizov A.N.2, Panyukov M.V.1, Butorina A.V.1, Polyaev B.A.1, Lobov A.N.1, Plotnikov V.P.1, Platonova A.V.3
-
Affiliations:
- N.I. Pirogov Russian National Research Medical University
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
- Kite School Storm
- Issue: Vol 27, No 5 (2021)
- Pages: 473-480
- Section: Clinical medicine
- URL: https://journals.rcsi.science/0869-2106/article/view/108915
- DOI: https://doi.org/10.17816/0869-2106-2021-27-5-473-480
- ID: 108915
Cite item
Abstract
BACKGROUND: The main function of the medial collateral ligament is static stabilization when the tibia is deviated outward. Medial collateral ligament damage may result from the application of a sharp force to the tibia and knee joint in a valgus position, often leading to knee instability, recurrent synovitis and posttraumatic osteoarthritis. This often results in the development of functional disorders that sharply limit the motor abilities of patients, thereby affecting the performance (support ability) of the injured limb.
AIM: The study aimed to conduct a comparative analysis of the efficiency of various current rehabilitation techniques providing a more patient-oriented approach in the conservative treatment of various degrees of medial collateral ligament injuries based on the assessment of the capabilities of magnetic resonance imaging in 38 patients.
MATERIALS AND METHODS: Thirty-eight patients (27 men and 11 women, 71.05% and 28.95%, respectively) with partial medial collateral ligament injuries were followed up. The mean age was 28.5 years (19–38 years). All subjects were involved in skiing and snowkiting in the “alpine skiing” discipline. The diagnosis was made based on clinical examination, patient’s complaints, and magnetic resonance imaging (MRI) of the knee joint. The examination was performed on a Vestra-2 magnetic resonance tomograph with a superconducting magnet and a magnetic field induction of 0.5 Tesla. Optimal for knee joint examination was a quadrature Surf-76 receiving and transmitting coil, which allowed the selection of a small field of view without artifacts or spatial distortion and increased the signal/noise ratio. The knee joints were examined twice: on the day of admission (maximum 1.5 days after injury) and at the end of the week 6 of conservative treatment.
RESULTS: Using the rehabilitation treatment program proposed by the authors in patients with medial collateral ligament injuries, a decrease in the severity of clinical symptoms and an improvement of functional characteristics were observed. Inclusion of the kinesiotaping technique led to a reduction of the treatment recovery period.
CONCLUSIONS: Current noninvasive diagnostic techniques (in particular, MRI) for bone tissues, articular cartilages, and periarticular soft tissues allow to determine the degree of damage to anatomical structures, choose the optimal conservative treatment method , and set the duration and extent of artificial immobilization and the terms of the onset of rehabilitation procedures for patients with partial injuries of the medial collateral ligaments. The results of the proposed rehabilitation treatment program for injuries of the medial knee ligament include a reduction of pain, synovitis and limping, and an improvement of muscle strength and elasticity and knee stability.
Full Text
##article.viewOnOriginalSite##About the authors
Vitaly Yu. Levkov
N.I. Pirogov Russian National Research Medical University
Author for correspondence.
Email: levkovv@ya.ru
ORCID iD: 0000-0002-4104-2886
MD, Cand. Sci. (Med.), assistant professor
Russian Federation, 1, Ostrovityanova, Moscow, 117997Mariya S. Ikonnikova
N.I. Pirogov Russian National Research Medical University
Email: Vasya_ikonnikova@mail.ru
Russian Federation, 1, Ostrovityanova, Moscow, 117997
Larisa B. Andronova
N.I. Pirogov Russian National Research Medical University
Email: larisaandronova@mail.ru
MD, Cand. Sci. (Med.)
Russian Federation, 1, Ostrovityanova, Moscow, 117997Andrey N. Remizov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
Email: andrey.remizov@fccho-moscow.ru
ORCID iD: 0000-0003-1918-0841
Russian Federation, Moscow
Maxim V. Panyukov
N.I. Pirogov Russian National Research Medical University
Email: maxim287@mail.ru
MD, Cand. Sci. (Med.)
Russian Federation, 1, Ostrovityanova, Moscow, 117997Antonina V. Butorina
N.I. Pirogov Russian National Research Medical University
Email: avbutorina@gmail.com
MD, Doc. Sci. (Med.), Рrofessor
Russian Federation, 1, Ostrovityanova, Moscow, 117997Boris A. Polyaev
N.I. Pirogov Russian National Research Medical University
Email: polyaev@sportmed.ru
MD, Dr. Sci. (Med.), Рrofessor
Russian Federation, 1, Ostrovityanova, Moscow, 117997Andrey N. Lobov
N.I. Pirogov Russian National Research Medical University
Email: a_lobov54@mail.ru
MD, Dr. Sci. (Med.), Professor
Russian Federation, 1, Ostrovityanova, Moscow, 117997Valeriy P. Plotnikov
N.I. Pirogov Russian National Research Medical University
Email: pronator@mail.ru
MD, Dr. Sci. (Med.), Рrofessor
Russian Federation, 1, Ostrovityanova, Moscow, 117997Aleksandra V. Platonova
Kite School Storm
Email: school@storm-kite.com
Russian Federation, Moscow
References
- Bychkov AE. Povrezhdeniya vnutrennei bokovoi svyazki kolennogo sustava. Bulletin of medical internet conferences. 2014;4(5):828. (In Russ).
- Deikalo VP, Boloboshkoch KB. Struktura travm i zabolevanii kolennogo sustava. Novosti khirurgii. 2007;15(1):26–31. (In Russ).
- Girshin SG, Lazishvili GD. Kolennyi sustav (povrezhdeniya i bolevye sindromy). Moscow; 2007. (In Russ).
- Popova SN, editor. Fizicheskaya reabilitatsiya: uchebnik dlya studentov vysshikh uchebnykh zavedenii. Moscow; 2013. (In Russ).
- Tsykunov MB. Rehabilitation programs of the damaged cartilage and capsular-ligamentous structures of the knee. Guidelines. Bulletin of rehabilitation medicine. 2014;(3):110–114. (In Russ).
- Mironov SP, Orletskii AK, Tsykunov MB. Povrezhdeniya svyazok kolennogo sustava. Klinika, diagnostika, lechenie. Moscow; 1999. Mironov SP, Orletskii AK, Tsykunov MB. Povrezhdeniya svyazok kolennogo sustava. Klinika, diagnostika, lechenie. Moscow; 1999. (In Russ).
- Bryukhanov AV, Vasil’ev AY. Magnitno-rezonansnaya tomografiya v osteologii. Moscow, 2006. (In Russ).
- Dzhumabekov SA, Baigaraev EA, Kazakov SK. Surgical treatment of injury of knees collateral ligament. Universum: Meditsina i farmakologiya. 2014;(12):26–31. (In Russ).
- Perova EI. Fizicheskaya reabilitatsiya posle travm kak uslovie povysheniya kachestva zhizni sportsmenov [dissertation]. Moscow; 2007. (In Russ).
- Callaghan JJ. The Adult Knee. Philadelphia: Lippincott Williams & Wilkins; 2003.
- Futryk AB. Diagnostika, lechenie i reabilitatsiya bol’nykh s povrezhdeniyami svyazok kolennogo sustava v ostrom periode travmy [dissertation]. Moscow; 2002. (In Russ).