Postoperative Rehailitation of Ligamentous Injury of Knee Using Limited Motion Brace

Kim, Jung Man; Park, Choong Seo

Abstract

The authors have reviewed 46 cases (38 males and 8 females) with ligamentous injuries of the knee in the Department. of Orthopaedic Surgery, St. Mary's Hostpital, Catholic Medical College and Center, during the period from Feb. 1983 to May 1985. The patients were divided into two groups according to the two different postoperative rehabilitation programs. In one group, rehabilitation was begun with limited motion brace from 2nd week postoperatively (Group I). In another group, a long leg circular cast was applied for 6 weeks postoperatively, followed by rehabilitation (Group II). All patients were allowed to bear full weight in 12 weeks postoperatively and were recommended to keep appling braces for at least 6 months postoperatively. Sports or other vigorous activities were allowed in one year postoperatively. Primary repair was performed in 14 cases in Group I (66.7%) and in 17 cases in Group II (68.0%). Reconstruction of ligament was performed in 7 cases in Group I (33.3%) and in 8 cases in Group II (32.0%). The results were analyzed in terms of range of motion, pain, instability and muscle power in each group according to O'Donoghue. The results were as follows: 1. Three months after operation, over 120 degrees in flexion was achieved in 18 cases in Group I (85.7%) and in 7 cases in Group II (28.0%). The recovery of range of motion was achieved earlier in Group I than in Group II. 2. Three months after operation, extension lag was seen in only 2 cases in Group I, all of which were below 10 degrees, and 13 cases in Group II of which 10 cases had extension lag of over 10 degrees. The recovery of muscle power was achieved earlier in Group I than in Group II. 3. Overall results showed "excellent" in 17 out of 21 cases in Group I (80.9%) and in 12 out of 25 cases in Group II (48.0%). In conclusion, the limited motion brace was effective in early recovery of range of motion and muscle power, without any significant loss of stability, after repair or even reconstruction of theligamenta of the knee, regardless of the type of injury, although the number of posterior cruciate ligament tears were too small to come to a concrete conclusion.