Rottura del legamento Crociato Anteriore del ginocchio :quando operarsi e la riabilitazione
Fisioterapia e Osteopatia a Brescia
Hai dolore al ginocchio per una lesione al legamento crociato anteriore?
Purtroppo è un situazione che accade spesso e non solo agli sportivi e ancora più spesso non viene affrontato dal giusto specialista.
Il Fisioterapista può sicuramente aiutarti a stare meglio e darti i consigli utili per tornare a star bene.
Qui ci occuperemo delle lesioni interne del ginocchio (che sono per lo piu’ conseguenze di brusche sollecitazioni in torsione o di traumi in adduzione o abduzione ) e piu’ in particolare delle lesioni del legamento crociato anteriore o comunemente detto LCA, nel nostri centro di Fisioterapia le trattiamo giornalmente. Questo legamento collega la parte antero/superiore della tibia alla parte postero/inferiore del femore ed impedisce alla tibia di scivolare in avanti sul femore.
Introduzione
La funzione articolare del ginocchio risente in grado più o meno marcato dei traumi che avvengono a distanza nel femore e nella gamba. L’interessamento diretto si verifica a seguito delle caratteristiche lesioni interne, delle fratture dei capi articolari e delle lussazioni.
Una delle situazioni per rompere questo legamento e’ un colpo diretto sul ginocchio e questo succede molto spesso nel gioco del calcio. Tuttavia la maggior parte delle rotture del LCA puo’ avvenire senza che vi sia contatto tra il ginocchio e qualche altro oggetto. Questi traumi avvengono quando gli atleti effettuano dei cambi di direzione molto repentini o atterrano con il ginocchio in iperestensione a seguito di un salto.
L’infortunio di solito e’ associato a un moderato o intenso dolore e nella maggior parte dei casi non si riesce a continuare l’attivita’ sportiva,nelle ore seguenti il ginocchio si gonfia e si fa difficolta’ anche a camminare.Il dolore e il gonfiore aumentano nei primi due giorni poi tendono a diminuire nei giorni successivi.
Il disagio che si prova dopo la rottura del LCA e’ talmente serio che la persona infortunata si rivolgera’ in maniera molto spontanea ad un ortopedico o un fisioterapista.In alcuni casi il gonfiore eccessivo e il dolore possono rendere difficile la visita e di conseguenza una diagnosi accurata. In questa circostanza si rende necessaria l’esecuzione di una risonanza magnetica effettuata in brevissimo tempo per effettuare una diagnosi precisa altrimenti la RM si effettua dopo 2-3 settimane per evitare dei falsi negativi e quindi dlle diagnosi non esatte.
Quando è necessaria l’operazione per il crociato del ginocchio
A questo punto la domanda che ognuno di noi si farebbe è: dovrò essere operato??
La risposta a questa domanda sara’ diversa da persona a persona, molti fattori devono essere presi in considerazione dal paziente e dal chirurgo, questi fattori includono l’eta’ del paziente il contesto sociale in cui e’ inserita la persona, la presenza di eventuali lesioni associate (catillagini,menischi etc.) .
Li dove si decidera’ di effettuare un intervento chirurgico e’ sempre consigliabile effettuare prima un ciclo di fisiokinesiterapia per migliorare la fisiologia del ginocchio il gonfiore e il dolore.
Esistono molti interventi chirurgici per riparare un LCA rotto, le tecniche attuali prevedono la ricostruzione del LCA utilizzando un nuovo legamento ottenuto dalla preparazione di un tessuto prelevato da uno degli altri tendini presenti intorno al ginocchio (gerneralmente il gracile associato al semitendinoso o dal tendine rotuleo), questo tessuto viene passato attraverso fori praticati nell’osso del femore e della tibia e poi ancorato in posizione corretta all’osso per creare un nuovo LCA.
La riabilitazione dopo un intervento di LCA richiede tempo e duro impegno, l’assenza dal lavoro sarà chiaramente dipendente dal tipo di lavoro svolto dal paziente che puo’ variare da due-tre settimane per chi fa fa un lavoro di ufficio per esempio, a tre-sei mesi per chi svolge lavori piu’ pesanti.
Articolo perso da www.fisioterapiaitalia.com
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