{"id":29131,"date":"2025-08-21T12:40:00","date_gmt":"2025-08-21T09:40:00","guid":{"rendered":"https:\/\/www.utkuerdemozer.com\/chirurgia-de-reparare-a-ligamentului-incrucisat-anterior-lia\/"},"modified":"2026-04-01T02:20:44","modified_gmt":"2026-03-31T23:20:44","slug":"chirurgia-de-reparare-a-ligamentului-incrucisat-anterior-lia","status":"publish","type":"post","link":"https:\/\/www.utkuerdemozer.com\/ro\/chirurgia-de-reparare-a-ligamentului-incrucisat-anterior-lia\/","title":{"rendered":"Chirurgia de Reparare a Ligamentului \u00cencruci\u0219at Anterior (LIA)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Ligamentul \u00eencruci\u0219at anterior (LIA) este una dintre cele mai importante structuri care asigur\u0103 stabilitatea articula\u021biei genunchiului. Atunci c\u00e2nd acest ligament este r\u0103nit sau rupt, controlul alunec\u0103rii \u00eenainte \u0219i al rota\u021biei genunchiului este compromis. \u00cen timp ce unele ligamente din corpul nostru se pot vindeca spontan, leziunile ligamentului \u00eencruci\u0219at anterior necesit\u0103 adesea interven\u021bie chirurgical\u0103. Timp de mul\u021bi ani, metoda de tratament standard de aur a fost reconstruc\u021bia ligamentului, adic\u0103 crearea unui nou ligament folosind un tendon prelevat din propriul \u021besut al pacientului sau dintr-o banc\u0103 de \u021besuturi, \u00een locul ligamentului rupt. Cu toate acestea, odat\u0103 cu dezvoltarea tehnicilor chirurgicale moderne, repararea ligamentului \u00eencruci\u0219at anterior a devenit, de asemenea, o op\u021biune de succes \u00een cazurile adecvate.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Ce este Ligamentul \u00cencruci\u0219at Anterior (LIA) \u0219i care este rolul s\u0103u \u00een genunchi?<\/strong><\/h2>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/utkuerdemozer.com\/wp-content\/uploads\/2025\/06\/f7cce4_3748f3aeb284451884a2600aaf5d91d6mv2-9.png\" alt=\"\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Ligamentul \u00eencruci\u0219at anterior (LIA) este una dintre cele mai importante structuri din interiorul articula\u021biei genunchiului, care leag\u0103 osul coapsei (femurul) de osul gambei (tibia) \u0219i asigur\u0103 stabilitatea articula\u021biei. \u00cen timpul mi\u0219c\u0103rii genunchiului, previne alunecarea \u00eenainte-\u00eenapoi a oaselor \u0219i men\u021bine echilibrul articula\u021biei \u00een mi\u0219c\u0103ri precum oprirea brusc\u0103, schimbarea direc\u021biei \u0219i aterizarea dup\u0103 s\u0103ritur\u0103. \u00cempreun\u0103 cu <a href=\"https:\/\/www.utkuerdemozer.com\/ro\/rupturi-de-menisc-medial\/\">meniscurile<\/a> \u0219i ligamentele colaterale, contribuie semnificativ la func\u021bia de sus\u021binere a greut\u0103\u021bii \u0219i la mi\u0219carea echilibrat\u0103.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Cum se produce o leziune a Ligamentului \u00cencruci\u0219at Anterior (LIA)?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Leziunile ligamentului \u00eencruci\u0219at anterior apar de obicei \u00een timpul mi\u0219c\u0103rilor precum oprirea brusc\u0103, schimbarea rapid\u0103 a direc\u021biei, aterizarea dezechilibrat\u0103 dup\u0103 un salt sau o r\u0103sucire brusc\u0103 a genunchiului. Sunt mai frecvente \u00een sporturile de contact sau de mare intensitate, cum ar fi fotbalul, baschetul, handbalul, voleiul \u0219i schiul. O \u201esenza\u021bie de ruptur\u0103\u201d \u00een genunchi \u00een momentul leziunii \u0219i umflarea care se dezvolt\u0103 \u00een c\u00e2teva ore sunt tipice.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Diferen\u021bele dintre Repararea Ligamentului \u00cencruci\u0219at Anterior \u0219i Chirurgia de Reconstruc\u021bie<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Tratamentul chirurgical al leziunilor ligamentului \u00eencruci\u0219at anterior poate fi realizat prin dou\u0103 metode principale:&nbsp;<strong>repara\u021bie<\/strong>&nbsp;sau&nbsp;<strong>reconstruc\u021bie<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Repararea ligamentului \u00eencruci\u0219at anterior<\/strong>&nbsp;este reata\u0219area ligamentului rupt la locul s\u0103u anatomic de inser\u021bie, cu p\u0103strarea \u021besutului propriu.<\/li>\n\n\n\n<li><strong><a href=\"https:\/\/www.utkuerdemozer.com\/ro\/chirurgia-de-reconstructie-a-ligamentului-incrucisat-anterior-lia\/\">Reconstruc\u021bia ligamentului \u00eencruci\u0219at anterior<\/a><\/strong>, pe de alt\u0103 parte, implic\u0103 crearea unui nou ligament \u00een locul celui rupt, folosind un tendon prelevat din corpul pacientului (autogref\u0103) sau un tendon ob\u021binut dintr-o banc\u0103 de \u021besuturi (alogref\u0103).<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Compara\u021bie Avantaje\u2013Dezavantaje<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th><strong>Caracteristic\u0103<\/strong><\/th><th><strong>Repararea Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/th><th><strong>Reconstruc\u021bia Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/th><\/tr><\/thead><tbody><tr><td><strong>Durata interven\u021biei<\/strong><\/td><td>Mai scurt\u0103<\/td><td>Mai lung\u0103<\/td><\/tr><tr><td><strong>Utilizarea \u021besutului<\/strong><\/td><td>Ligamentul existent este p\u0103strat, nu se preleveaz\u0103 tendon suplimentar<\/td><td>Necesit\u0103 autogref\u0103 sau alogref\u0103<\/td><\/tr><tr><td><strong>Timp de recuperare<\/strong><\/td><td>Poate fi mai rapid<\/td><td>Proces de reabilitare mai lung<\/td><\/tr><tr><td><strong>Criterii de eligibilitate<\/strong><\/td><td>Cazuri selectate (pacien\u021bi tineri, leziuni recente, ruptur\u0103 aproape de inser\u021bia femural\u0103)<\/td><td>Adecvat pentru majoritatea pacien\u021bilor<\/td><\/tr><tr><td><strong>Risc de re-ruptur\u0103<\/strong><\/td><td>Sc\u0103zut la pacien\u021bii potrivi\u021bi<\/td><td>Sc\u0103zut, dar exist\u0103 riscul de e\u0219ec al grefei<\/td><\/tr><tr><td><strong>Rezultate pe termen lung<\/strong><\/td><td>Succes la pacien\u021bii potrivi\u021bi<\/td><td>Ratp de succes ridicat\u0103, standard de aur<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Ce metod\u0103 este mai bun\u0103?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Ambele metode au avantaje specifice.&nbsp;<strong>Interven\u021bia chirurgical\u0103 de reparare<\/strong>&nbsp;este preferat\u0103 doar la pacien\u021bii \u0219i \u00een tipurile de rupturi adecvate. Reconstruc\u021bia, pe de alt\u0103 parte, este o metod\u0103 acceptat\u0103 ca standard de aur de mul\u021bi ani \u0219i aplicabil\u0103 unui grup mai larg de pacien\u021bi. Decizia se ia \u00een func\u021bie de factori precum v\u00e2rsta pacientului, tipul leziunii, localizarea rupturii \u0219i starea general\u0103 a ligamentului.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Tehnici Chirurgicale Moderne \u0219i Evolu\u021bii Tehnologice \u00een Tratamentul Leziunilor Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Repararea ligamentului \u00eencruci\u0219at anterior a avut rate de succes limitate \u00een trecut, motiv pentru care interven\u021bia chirurgical\u0103 de reconstruc\u021bie a fost preferat\u0103 timp de mul\u021bi ani. Cu toate acestea, \u00een ultimii ani, odat\u0103 cu dezvoltarea tehnicilor de <strong><a href=\"https:\/\/www.utkuerdemozer.com\/ro\/chirurgie-sportiva-si-artroscopie\/\">chirurgie artroscopic\u0103<\/a><\/strong>, progresele \u00een biomateriale \u0219i apari\u021bia noilor sisteme de sutur\u0103, interven\u021biile chirurgicale de reparare au revenit \u00een aten\u021bie.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>1. Chirurgia Artroscopic\u0103 (Minim Invaziv\u0103)<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Interven\u021biile chirurgicale moderne de reparare a ligamentului \u00eencruci\u0219at anterior sunt efectuate cu ajutorul&nbsp;<strong>tehnicii artroscopice<\/strong>, realizate prin incizii mici \u0219i cu asisten\u021b\u0103 video. Prin aceast\u0103 metod\u0103:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Articula\u021bia este minim lezat\u0103.<\/li>\n\n\n\n<li>Se produce un traumatism tisular mai mic.<\/li>\n\n\n\n<li>Procesul de recuperare este accelerat, iar riscul de complica\u021bii este redus.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>2. Sus\u021binere Intern\u0103 (Internal Bracing)<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Peste ligamentul reparat se plaseaz\u0103 o band\u0103 sintetic\u0103 special\u0103 de \u00eenalt\u0103 rezisten\u021b\u0103 (band\u0103 de fibr\u0103). Aceast\u0103 band\u0103 este fixat\u0103 at\u00e2t pe partea osului coapsei (femurul), c\u00e2t \u0219i pe partea osului gambei (tibia).<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Scopul este de a reduce sarcina asupra ligamentului \u00een timpul procesului de vindecare \u0219i de a diminua riscul de re-ruptur\u0103.<\/li>\n\n\n\n<li>Permite reabilitarea timpurie la sportivi.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>3. Tehnici \u0219i Materiale de Sutur\u0103 Avansate<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Suturile \u0219i sistemele de fixare utilizate \u00een metodele de reparare anterioare nu erau suficient de durabile. \u00cen prezent:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fire de sutur\u0103 de \u00eenalt\u0103 rezisten\u021b\u0103<\/li>\n\n\n\n<li>\u0218uruburi resorbabile<\/li>\n\n\n\n<li>Sunt utilizate sisteme tip \u201ebutton\u201d care asigur\u0103 fixarea f\u0103r\u0103 a leza \u021besuturile.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>4. Suport Biologic (Biologic Augmentation)<\/strong><\/h3>\n\n\n<p>Pentru a accelera vindecarea \u0219i a cre\u0219te rezisten\u021ba biomecanic\u0103 a ligamentului, metode de suport biologic pot fi aplicate \u00een timpul sau dup\u0103 interven\u021bia chirurgical\u0103 de reparare:<\/p>\n<p><!-- \/wp:post-content --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong><a href=\"https:\/\/www.utkuerdemozer.com\/ro\/tratament-prp\/\">Injec\u021bia cu PRP (Plasma Bogat\u0103 \u00een Plachete)<\/a><\/strong><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong><a href=\"https:\/\/www.utkuerdemozer.com\/ro\/terapia-cu-celule-stem\/\">Aplica\u021bii de celule stem: derivate din gr\u0103sime \u0219i din m\u0103duva osoas\u0103<\/a><\/strong><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Tehnici de \u00eenf\u0103\u0219urare cu\u00a0<strong>membrane biologice<\/strong><\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:paragraph --><\/p>\n<p>Aceste metode pot influen\u021ba pozitiv procesul de vindecare, \u00een special la pacien\u021bii tineri \u0219i activi.<\/p>\n<p><!-- \/wp:paragraph --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Reabilitarea \u0219i Procesul de Revenire la Sport dup\u0103 Repararea Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:paragraph {\"translatedWithWPMLTM\":\"1\"} --><\/p>\n<p>Aceast\u0103 metod\u0103 nu este o interven\u021bie chirurgical\u0103 clasic\u0103 de reconstruc\u021bie a ligamentului \u00eencruci\u0219at anterior, iar protocolul de reabilitare este diferit. Dac\u0103 medicul chirurg nu ofer\u0103 instruc\u021biuni contrare, trebuie urmat protocolul special de reabilitare men\u021bionat mai jos. Este important de re\u021binut c\u0103, pentru a ob\u021bine un rezultat de succes dup\u0103 repararea ligamentului \u00eencruci\u0219at anterior, un alt factor la fel de important ca interven\u021bia chirurgical\u0103 este\u00a0<strong>programul de reabilitare<\/strong>. Exerci\u021biile postoperatorii, planul de \u00eenc\u0103rcare \u0219i momentul revenirii la sport asigur\u0103 at\u00e2t protejarea ligamentului reparat, c\u00e2t \u0219i restabilirea func\u021biei anterioare a genunchiului.<\/p>\n<p><!-- \/wp:paragraph --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Preg\u0103tirea Preoperatorie pentru Interven\u021bia de Reparare a Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Pacientul trebuie s\u0103 \u00eenceap\u0103 exerci\u021biile la domiciliu \u00een prima s\u0103pt\u0103m\u00e2n\u0103 postoperatorie. Aceste exerci\u021bii trebuie predate pacientului \u00eenainte de opera\u021bie.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021biile trebuie revizuite \u00een prima \u0219edin\u021b\u0103 de fizioterapie postoperatorie \u0219i evaluate pentru forma \u0219i frecven\u021ba corecte.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Situa\u021bia Sus\u021binerii Greut\u0103\u021bii dup\u0103 Interven\u021bia de Reparare a Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Ini\u021bial, se aplic\u0103\u00a0<strong>\u00eenc\u0103rcare par\u021bial\u0103<\/strong>.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Timp de primele 4 s\u0103pt\u0103m\u00e2ni, se permite \u00eenc\u0103rcare par\u021bial\u0103, cu\u00a0<strong>orteza blocat\u0103 \u00een extensie complet\u0103 (0\u00b0)<\/strong>.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cencep\u00e2nd cu s\u0103pt\u0103m\u00e2na a 4-a, cu acordul fizioterapeutului \u0219i al chirurgului, se poate trece la faza de\u00a0<strong>\u00eenc\u0103rcare complet\u0103 \u00een limita durerii<\/strong>\u00a0\u0219i renun\u021barea la c\u00e2rje, dac\u0103 sunt \u00eendeplinite urm\u0103toarele criterii:<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Capacitatea de a men\u021bine un model normal de mers<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Absen\u021ba durerii<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Extensie complet\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Control bun al cvadricepsului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a urca \u0219i cobor\u00ee sc\u0103ri f\u0103r\u0103 durere sau instabilitate<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Utilizarea Ortezei<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:paragraph {\"translatedWithWPMLTM\":\"1\"} --><\/p>\n<p>Dup\u0103 interven\u021bia chirurgical\u0103,\u00a0<strong>orteza reglabil\u0103 \u00een unghi<\/strong>\u00a0trebuie utilizat\u0103 \u00een timpul activit\u0103\u021bilor de sus\u021binere a greut\u0103\u021bii:<\/p>\n<p><!-- \/wp:paragraph --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>\u00cen primele 4 s\u0103pt\u0103m\u00e2ni, trebuie s\u0103 fie blocat\u0103 la 0\u00b0 \u00een timpul mersului.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cen primele 6 s\u0103pt\u0103m\u00e2ni, trebuie s\u0103 r\u0103m\u00e2n\u0103 blocat\u0103 la 0\u00b0 \u00een timpul somnului.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cencep\u00e2nd cu s\u0103pt\u0103m\u00e2na a 2-a, poate fi deschis\u0103 p\u00e2n\u0103 la unghiul stabilit pentru antrenamentul de mers \u00een pozi\u021bie \u0219ez\u00e2nd\u0103 sau \u00een timpul fizioterapiei.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cen s\u0103pt\u0103m\u00e2na a 4-a, dac\u0103 pacientul a restabilit controlul cvadricepsului \u0219i se simte confortabil, orteza poate fi utilizat\u0103 \u00een pozi\u021bie deschis\u0103 \u00een timpul \u00eenc\u0103rc\u0103rii par\u021biale (flexia mai mare de 90\u00b0 nu este permis\u0103 \u00een primele 4 s\u0103pt\u0103m\u00e2ni).<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:paragraph --><\/p>\n<p><strong>Amplitudinea de Mi\u0219care a Ortezei Utilizate dup\u0103 Interven\u021bia de Reparare a Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:table --><\/p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<thead>\n<tr>\n<th><strong>Interval de Timp<\/strong><\/th>\n<th><strong>Interval de Unghi Permis<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Primele 24 de ore<\/td>\n<td>Blocat la 0\u00b0 (blocat la adolescen\u021bi p\u00e2n\u0103 la primul control post-operator al chirurgului)<\/td>\n<\/tr>\n<tr>\n<td>0 \u2013 2 s\u0103pt\u0103m\u00e2ni<\/td>\n<td>0\u00b0 \u2013 45\u00b0<\/td>\n<\/tr>\n<tr>\n<td>2 \u2013 4 s\u0103pt\u0103m\u00e2ni<\/td>\n<td>0\u00b0 \u2013 90\u00b0<\/td>\n<\/tr>\n<tr>\n<td>4 \u2013 6 s\u0103pt\u0103m\u00e2ni<\/td>\n<td>Se progreseaz\u0103 spre amplitudinea complet\u0103 de mi\u0219care a articula\u021biei, \u00een limitele toleran\u021bei<\/td>\n<\/tr>\n<tr>\n<td>6 \u2013 14 s\u0103pt\u0103m\u00e2ni<\/td>\n<td>Dac\u0103 chirurgul dore\u0219te, se trece la o ortez\u0103 func\u021bional\u0103 (atunci c\u00e2nd amplitudinea activ\u0103 de mi\u0219care a articula\u021biei este 0\u00b0 \u2013 \u2265110\u00b0)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/figure>\n<p><!-- \/wp:table --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Alte Recomand\u0103ri<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>Masajul cicatricial:<\/strong>\u00a0Nu trebuie aplicat p\u00e2n\u0103 \u00een Faza 3.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Mi\u0219carea pasiv\u0103 manual\u0103 a articula\u021biei:<\/strong>\u00a0Nu trebuie efectuat\u0103 \u00een niciun fel \u00een perioadele fazelor 1\u20133 ale protocolului.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>CPM (Mi\u0219care Pasiv\u0103 Continu\u0103):<\/strong>\u00a0Nu trebuie utilizat\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Utilizarea vehiculului:<\/strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Pacientul nu trebuie s\u0103 conduc\u0103 p\u00e2n\u0103 c\u00e2nd nu \u00eenceteaz\u0103 administrarea tuturor medicamentelor narcotice.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>La pacien\u021bii opera\u021bi la piciorul drept; trebuie s\u0103 poat\u0103 sus\u021bine greutatea complet\u0103 f\u0103r\u0103 c\u00e2rje \u0219i s\u0103 ating\u0103 o flexie a genunchiului de cel pu\u021bin 60\u00b0.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Persoanele care desf\u0103\u0219oar\u0103 munci fizice:<\/strong>\u00a0Restric\u021biile sunt determinate \u00een conformitate cu recomand\u0103rile chirurgului care a efectuat interven\u021bia \u0219i protocolul de fizioterapie relevant.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Fortificarea muscular\u0103:<\/strong>\u00a0Pot fi utilizate doar urm\u0103toarele metode:<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>NMES (Stimulare Electric\u0103 Neuromuscular\u0103)<\/strong><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Op\u021bional, la pacien\u021bii cu durere sau toleran\u021b\u0103 sc\u0103zut\u0103 la \u00eenc\u0103rcare,\u00a0<strong>antrenament cu restric\u021bie a fluxului sanguin (BFR) de intensitate sc\u0103zut\u0103<\/strong><\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Dac\u0103 se observ\u0103 rigiditate articular\u0103:<\/strong><!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Trebuie s\u0103 ne asigur\u0103m c\u0103 durerea \u0219i umfl\u0103tura sunt controlate corect.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Trebuie s\u0103 ne asigur\u0103m c\u0103 pacientul respect\u0103 protocolul de reabilitare recomandat pentru interven\u021bia de reparare a ligamentului \u00eencruci\u0219at anterior.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 0: Fizioterapie Preoperatorie \u0219i Prima S\u0103pt\u0103m\u00e2n\u0103 Postoperatorie<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Recomand\u0103ri Preoperatorii<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:paragraph {\"translatedWithWPMLTM\":\"1\"} --><\/p>\n<p><strong>Obiectivele Fazei:<\/strong>\u00a0Trebuie \u00eenceput c\u00e2t mai cur\u00e2nd posibil dup\u0103 leziunea ini\u021bial\u0103 \u0219i trebuie atinse urm\u0103toarele obiective preoperatorii:<\/p>\n<p><!-- \/wp:paragraph --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Asigurarea extensiei complete active \u0219i pasive a genunchiului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Amplitudinea de mi\u0219care a flexiei genunchiului s\u0103 fie cu cel mult 10\u00b0 mai mic\u0103 dec\u00e2t pe partea s\u0103n\u0103toas\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Prezen\u021ba doar a unei epan\u0219amente articulare foarte u\u0219oare sau a absen\u021bei acesteia \u00een genunchi<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Absen\u021ba deficitului de extensie la ridicarea piciorului drept (SLR)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Indicele de For\u021b\u0103 a Cvadricepsului (QI) s\u0103 fie de cel pu\u021bin 80% din partea s\u0103n\u0103toas\u0103 \u2192 aceste valori trebuie \u00eenregistrate pentru compara\u021bia postoperatorie (pentru a preveni supraestimarea for\u021bei)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Pacientului\/tutorelui i se vor preda exerci\u021biile la domiciliu la ultima vizit\u0103 preoperatorie. Importan\u021ba aderen\u021bei la reabilitare trebuie subliniat\u0103 \u00een mod special.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Trebuie oferit\u0103 instruire privind utilizarea ortezei, a c\u00e2rjelor \u0219i \u00eenc\u0103rcarea par\u021bial\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Educa\u021bia Pacientului<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Explicarea importan\u021bei reabilit\u0103rii preoperatorii pentru cele mai bune rezultate postoperatorii<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Explicarea a ceea ce trebuie f\u0103cut \u00een primele 48 de ore postoperatorii<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Termenul estimat pentru revenirea la sport:\u00a0<strong>9\u201312 luni<\/strong><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Rezultate a\u0219teptate: Revenirea la nivelul sportiv anterior, de\u0219i dificil\u0103, este posibil\u0103<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 1: S\u0103pt\u0103m\u00e2nile 1\u20134<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:paragraph --><\/p>\n<p><strong>Program la Domiciliu \u2013 Sub Supravegherea Fizioterapeutului &amp; Controlul Chirurgului \u00een S\u0103pt\u0103m\u00e2nile 1\u20132<\/strong><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\">Instruc\u021biuni Importante<\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Instruc\u021biunile Postoperatorii \u0219i Exerci\u021biile la Domiciliu trebuie revizuite \u00een prima vizit\u0103 postoperatorie la chirurg \u0219i \u00een \u0219edin\u021bele de fizioterapie din s\u0103pt\u0103m\u00e2nile 1 \u0219i 2, iar aplicarea corect\u0103 trebuie re\u00eenv\u0103\u021bat\u0103 pacientului.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Utilizarea C\u00e2rjelor<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>\u00cencep\u00e2nd cu ziua opera\u021biei, pacien\u021bii pot \u00eencepe s\u0103 mearg\u0103 cu\u00a0<strong>\u00eenc\u0103rcare par\u021bial\u0103 (p\u00e2n\u0103 la 50%)<\/strong>.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cen timpul mersului, orteza trebuie s\u0103 fie blocat\u0103 la 0\u00b0.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cen timpul exerci\u021biilor de flexie, orteza poate fi deschis\u0103 \u00een intervalele specificate \u00een protocol.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Criteriile pentru trecerea la \u00eenc\u0103rcarea complet\u0103 trebuie \u00eendeplinite cel mai devreme \u00een s\u0103pt\u0103m\u00e2na a 4-a \u0219i cel t\u00e2rziu \u00een s\u0103pt\u0103m\u00e2na a 6-a.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4,\"translatedWithWPMLTM\":\"1\"} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Ortez\u0103\u00a0<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Se men\u021bine blocat\u0103 la 0\u00b0 \u00een primele 24 de ore.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Ulterior, orteza articulat\u0103 se ajusteaz\u0103 astfel:<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>0\u20132 s\u0103pt\u0103m\u00e2ni:<\/strong>\u00a0Interval 0\u00b0\u201345\u00b0 \u00een pozi\u021bie \u0219ez\u00e2nd\u0103 \u0219i \u00een timpul exerci\u021biilor<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>2\u20134 s\u0103pt\u0103m\u00e2ni:<\/strong>\u00a0Interval 0\u00b0\u201390\u00b0 \u00een pozi\u021bie \u0219ez\u00e2nd\u0103 \u0219i \u00een timpul exerci\u021biilor<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>\u00cen timpul mersului:<\/strong>\u00a0Blocat\u0103 la 0\u00b0 \u00een primele 2 s\u0103pt\u0103m\u00e2ni; dup\u0103 s\u0103pt\u0103m\u00e2na a 2-a, poate fi deschis\u0103 pentru antrenamentul de mers \u0219i activit\u0103\u021bi zilnice<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>\u00cen timpul somnului:<\/strong>\u00a0Trebuie utilizat\u0103 blocat\u0103 la 0\u00b0 pe durata primelor 4 s\u0103pt\u0103m\u00e2ni<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Performan\u021ba Muscular\u0103 \u0219i Exerci\u021bii<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:paragraph --><\/p>\n<p>Pacien\u021bii trebuie s\u0103 \u00eenceap\u0103 aceste exerci\u021bii \u00een prima s\u0103pt\u0103m\u00e2n\u0103. Flexia genunchiului nu trebuie s\u0103 dep\u0103\u0219easc\u0103 intervalele de unghi specificate.<\/p>\n<p><!-- \/wp:paragraph --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>Exerci\u021bii de extensie:<\/strong>\u00a0De 2 ori pe zi, 4\u20135 minute<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Exerci\u021bii de flexie (ex: alunecare pe perete):<\/strong>\u00a0De 2 ori pe zi, 1\u20132 seturi x 10 repet\u0103ri, men\u021binere 5\u201310 secunde<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Seturi de cvadriceps:<\/strong>\u00a0De 2\u20133 ori pe zi, 3 seturi x 10 repet\u0103ri (mi\u0219carea patellar\u0103 \u00een sus trebuie controlat\u0103 vizual \u0219i prin palpare)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Mobiliz\u0103ri patellare:<\/strong>\u00a0\u00cen direc\u021biile medial-lateral, superior-inferior<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>NMES (Stimulare Electric\u0103 Neuromuscular\u0103)<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Se aplic\u0103 atunci c\u00e2nd genunchiul este \u00een extensie complet\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Trebuie asigurat\u0103 o contrac\u021bie tetanic\u0103 complet\u0103 a mu\u0219chiului cvadriceps (f\u0103r\u0103 fibrila\u021bie, mi\u0219carea patellar\u0103 \u00een sus trebuie observat\u0103).<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Intensitatea stimulului este crescut\u0103 p\u00e2n\u0103 la nivelul maxim tolerat de pacient.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>10\u201315 repet\u0103ri, fiecare contrac\u021bie 10 secunde, 50 secunde pauz\u0103 \u00eentre ele.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Pozi\u021bionarea electrozilor: distal central\/medial, proximal central\/lateral, trebuie utiliza\u021bi electrozi mari.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Aplicare Rece<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Se aplic\u0103 \u00eempreun\u0103 cu compresie \u0219i eleva\u021bie.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Primele 24 de ore \/ p\u00e2n\u0103 la controlul inflama\u021biei acute:<\/strong>\u00a015 minute \u00een fiecare or\u0103 de veghe.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Ulterior:<\/strong>\u00a0De 3 ori pe zi, 15 minute.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Nu trebuie dormit \u00een timp ce dispozitivul este \u00een func\u021biune.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00centre piele \u0219i dispozitiv trebuie s\u0103 existe \u00eentotdeauna un strat de \u021bes\u0103tur\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- wp:heading {\"level\":3} --><!-- wp:list --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Criterii de Trecere la Faza 2 (4 S\u0103pt\u0103m\u00e2ni Postoperatoriu)<\/strong><\/h3>\n<p><!-- \/wp:list --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Atingerea unui model normal de mers<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Mers f\u0103r\u0103 durere<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Control bun al cvadricepsului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Atingerea obiectivelor protocolului privind amplitudinea de mi\u0219care a articula\u021biei<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 2: S\u0103pt\u0103m\u00e2nile 4\u20138<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Obiective<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list {\"ordered\":true} --><\/p>\n<ol class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Asigurarea extensiei complete a genunchiului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Amplitudinea de mi\u0219care a flexiei genunchiului s\u0103 dep\u0103\u0219easc\u0103 90\u00b0<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Ob\u021binerea unei bune contrac\u021bii izometrice a cvadricepsului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Minimizarea durerii \u0219i a umfl\u0103turii<\/li>\n<p><!-- \/wp:list-item --><\/ol>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Recomand\u0103ri<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Utilizarea C\u00e2rjelor<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Cu acordul fizioterapeutului \u0219i al chirurgului, \u00een s\u0103pt\u0103m\u00e2na a 4-a, se poate trece de la\u00a0<strong>\u00eenc\u0103rcarea par\u021bial\u0103 (PWB) \u2192 la \u00eenc\u0103rcarea complet\u0103 \u00een limita durerii (WBAT)<\/strong>\u00a0\u0219i la renun\u021barea la c\u00e2rje.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Pentru aceasta, trebuie \u00eendeplinite urm\u0103toarele criterii:<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Recuperarea unui model normal de mers<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Absen\u021ba durerii<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Absen\u021ba lag-ului extensor (f\u0103r\u0103 pierdere de extensie la genunchi \u00een timpul SLR complet)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Control bun al cvadricepsului<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Revenirea la un model normal de mers trebuie sus\u021binut\u0103 prin exerci\u021bii de mers \u00een cadrul clinicii \u00eencep\u00e2nd cu s\u0103pt\u0103m\u00e2na a 2-a.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Ortez\u0103<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>S\u0103pt\u0103m\u00e2nile 2\u20134:<\/strong>\u00a0Intervalul ortezei este ajustat la 0\u201390\u00b0.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Odat\u0103 atins\u0103 flexia de 90\u00b0, se poate progresa pentru a permite amplitudinea complet\u0103 de mi\u0219care.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>C\u00e2nd controlul cvadricepsului revine, orteza poate fi deschis\u0103 \u00een timpul \u00eenc\u0103rc\u0103rii \u0219i mersului.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Dup\u0103 s\u0103pt\u0103m\u00e2na a 6-a, utilizarea ortezei \u00een timpul somnului este oprit\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Amplitudinea de Mi\u0219care a Articula\u021biei (ROM)<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>Extensie:<\/strong>\u00a0\u00centindere cu \u00eenc\u0103rcare redus\u0103\u2013durat\u0103 lung\u0103 (~5 min) \u2192 de exemplu, suport sub c\u0103lc\u00e2i (heel prop). Dac\u0103 este necesar, se poate efectua \u00eentindere suplimentar\u0103 ag\u0103\u021b\u00e2nd o greutate (sac\/geant\u0103) pe genunchi (bag hang).<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Mobilizarea patellar\u0103:<\/strong>\u00a0Se efectueaz\u0103 ini\u021bial \u00een direc\u021biile medial-lateral, apoi superior-inferior. Efectul asupra epan\u0219amentului \u0219i ROM trebuie monitorizat.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Nu trebuie efectuat\u0103 mi\u0219care pasiv\u0103 manual\u0103 pentru flexie.<\/strong><\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Activarea \u0219i Fortificarea Muscular\u0103<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Seturile de cvadriceps se efectueaz\u0103, accentu\u00e2ndu-se participarea activ\u0103 a tuturor fibrelor musculare.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Exerci\u021bii de cvadriceps cu arc lung:<\/strong>\u00a0Se aplic\u0103 \u00een intervalul 90\u00b0\u20130\u00b0.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Ridicarea piciorului drept (SLR):<\/strong>\u00a0Trebuie efectuat\u0103 f\u0103r\u0103 lag extensor.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cen s\u0103pt\u0103m\u00e2nile 4\u20136, \u00eencepe antrenamentul pentru urcarea \u0219i cobor\u00e2rea sc\u0103rilor.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>NMES (Stimulare Electric\u0103 Neuromuscular\u0103)<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Trebuie continuat\u0103 p\u00e2n\u0103 c\u00e2nd Indicele de Simetrie a Membrelor pentru Cvadriceps\u00a0<strong>(Limb Symmetry Index) \u2265 80%<\/strong>\u00a0este atins.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Gestionarea Rigidit\u0103\u021bii Articulare<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:paragraph --><\/p>\n<p>Rigiditatea poate fi frecvent\u0103 \u00een aceast\u0103 faz\u0103 \u0219i este, \u00een general, asociat\u0103 cu:<\/p>\n<p><!-- \/wp:paragraph --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Frica de durere (fear avoidance),<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Non-aderen\u021ba la reabilitare,<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Proceduri chirurgicale suplimentare, cum ar fi repararea meniscului.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:paragraph --><\/p>\n<p><strong>M\u0103suri:<\/strong><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Controlul corect al durerii \u0219i al umfl\u0103turii<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Asigurarea respect\u0103rii protocolului de c\u0103tre pacient<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Dac\u0103 chirurgul a recomandat un protocol diferit, trebuie consultat chirurgul \u00eenainte de a \u00eentreprinde orice ac\u021biune.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:paragraph --><\/p>\n<p><strong>Recomand\u0103ri suplimentare:<\/strong><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Continuarea aplic\u0103rii regulate a exerci\u021biilor<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Efectuarea mobiliz\u0103rilor patellare mai frecvent \u0219i la un nivel avansat<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00centindere cu greutate ag\u0103\u021bat\u0103 pe genunchi \u00een pozi\u021bie supin\u0103 (weighted supine bag hangs)<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Criterii de Trecere la Faza 3 (8 S\u0103pt\u0103m\u00e2ni Postoperatoriu)<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Asigurarea extensiei complete a genunchiului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Flexia genunchiului s\u0103 fie peste 90\u00b0<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 3: S\u0103pt\u0103m\u00e2nile 8\u201312<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Obiective<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list {\"ordered\":true} --><\/p>\n<ol class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Men\u021binerea durerii \u0219i a umfl\u0103turii la minimum<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Extensie complet\u0103 a genunchiului; flexia s\u0103 fie cu cel mult 15\u00b0 mai mic\u0103 dec\u00e2t pe partea s\u0103n\u0103toas\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Control bun al cvadricepsului (capabil s\u0103 efectueze SLR f\u0103r\u0103 lag \u00een \u226520 repet\u0103ri)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Asigurarea unui model normal de mers<\/li>\n<p><!-- \/wp:list-item --><\/ol>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>C\u00e2rje<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>WBAT (\u00eenc\u0103rcare complet\u0103 \u00een limita durerii)<\/strong>\u00a0continu\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Criterii pentru renun\u021barea la c\u00e2rje:<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Atingerea unui model normal de mers<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a urca \u0219i cobor\u00ee sc\u0103ri \u00een siguran\u021b\u0103, f\u0103r\u0103 durere \u0219i instabilitate (cu pa\u0219i alternan\u021bi, reciprocal stair climbing)<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Ortez\u0103<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Dac\u0103 chirurgul consider\u0103 necesar, se poate trece la\u00a0<strong>orteza ACL func\u021bional\u0103<\/strong>\u00a0atunci c\u00e2nd amplitudinea activ\u0103 de mi\u0219care a flexiei genunchiului (AROM) este \u2265110\u00b0.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cen timpul mersului \u0219i al activit\u0103\u021bilor cu lan\u021b cinematic \u00eenchis (biciclet\u0103, eliptic, pres\u0103 pentru picioare, alunecare pe perete, mini-genuflexiuni etc.), se poate utiliza o ortez\u0103 articulat\u0103 sau o ortez\u0103 func\u021bional\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\">Amplitudinea de Mi\u0219care a Articula\u021biei (ROM)<\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>Extensie:<\/strong>\u00a0\u00centindere cu \u00eenc\u0103rcare redus\u0103\u2013durat\u0103 lung\u0103 (~5 min) \u2192 suport sub c\u0103lc\u00e2i (heel prop) sau \u00eentindere cu greutate (bag hang).<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Flexie:<\/strong>\u00a0Exerci\u021bii AROM \/ AAROM \u2192 alunecare pe perete, alunecare a c\u0103lc\u00e2iului, flexie activ\u0103-asistat\u0103 \u00een pozi\u021bie \u0219ez\u00e2nd\u0103 (nu se va efectua flexie pasiv\u0103 manual\u0103).<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Biciclet\u0103:<\/strong>\u00a0Amplitudinea de mi\u0219care poate fi crescut\u0103 prin mi\u0219carea de balansare \u00eenainte-\u00eenapoi (rocking-for-range).<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Activarea \u0219i Fortificarea Muscular\u0103<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Seturi de cvadriceps (se accentueaz\u0103 activarea \u00een special a vastului lateral \u0219i vastului medial).<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii SLR f\u0103r\u0103 lag.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Stimulare electric\u0103 \u2192 Se continu\u0103 p\u00e2n\u0103 c\u00e2nd Indicele Cvadricepsului (QI) este \u226580%.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Alunecare pe perete cu ambele picioare sau mini-genuflexiuni (av\u00e2nd grij\u0103 ca genunchiul s\u0103 nu dep\u0103\u0219easc\u0103 nivelul picioarelor).<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Seturi de ischiogambieri \u2192 flexia trebuie efectuat\u0103 \u00een m\u0103sura toleran\u021bei pacientului.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Fortificarea musculaturii \u0219oldului \u2192 adduc\u021bie\/abduc\u021bie \u00een decubit lateral, extensie de \u0219old \u00een decubit ventral.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de co-contrac\u021bie cvadriceps\/ischiogambieri \u00een pozi\u021bie supin\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Extensii de genunchi \u00een lan\u021b deschis \u2192 cu rezisten\u021b\u0103 progresiv\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Antrenament pentru urcarea \u0219i cobor\u00e2rea sc\u0103rilor.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Aqua jogging (alergare \u00een piscin\u0103)<\/strong>\u00a0\u2192 poate fi \u00eenceput\u0103 din s\u0103pt\u0103m\u00e2na a 8-a.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>NMES (Stimulare Electric\u0103 Neuromuscular\u0103)<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Trebuie continuat\u0103 p\u00e2n\u0103 c\u00e2nd QI \u226580%.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Control Neuromuscular<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de transfer de greutate<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de repozi\u021bionare a unghiului articular<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Criterii de Trecere la Faza 4 (\u226512 S\u0103pt\u0103m\u00e2ni Postoperatoriu)<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Capacitatea de a efectua 20 de repet\u0103ri de ridicare a piciorului drept \u00een extensie complet\u0103.<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Atingerea unui model normal de mers<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cencetarea utiliz\u0103rii c\u00e2rjelor \/ imobilizatorului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Amplitudinea de mi\u0219care a articula\u021biei: deficit activ de extensie \u22645\u00b0, flexie activ\u0103 \u226590\u00b0<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Indicele Cvadricepsului (QI) s\u0103 fie \u00een intervalul 60\u201380%<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 4: S\u0103pt\u0103m\u00e2nile 12\u201320<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Obiective<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list {\"ordered\":true} --><\/p>\n<ol class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Amplitudine complet\u0103 de mi\u0219care \u00een extensie; flexia cu cel mult 10\u00b0 mai mic\u0103 dec\u00e2t genunchiul s\u0103n\u0103tos<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Cre\u0219terea for\u021bei musculare<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Progresul \u00een exerci\u021biile de reeducare neuromuscular\u0103<\/li>\n<p><!-- \/wp:list-item --><\/ol>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Amplitudinea de Mi\u0219care a Articula\u021biei (ROM)<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>\u00centindere cu \u00eenc\u0103rcare redus\u0103\u2013durat\u0103 lung\u0103 (cu asisten\u021b\u0103, dac\u0103 este necesar)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Alunec\u0103ri de c\u0103lc\u00e2i (heel slides) \/ alunec\u0103ri pe perete (wall slides)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Suport sub c\u0103lc\u00e2i (heel prop) sau \u00eentindere cu greutate (bag hang) \u2013 co-contrac\u021bia \u0219i r\u0103spunsul receptorilor de durere trebuie minimizate<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Biciclet\u0103 \u2192 mai \u00eent\u00e2i mi\u0219care de balansare (rocking-for-range), apoi pedalare cu \u0219aua ridicat\u0103, \u0219aua este cobor\u00e2t\u0103 treptat pe m\u0103sur\u0103 ce ROM progreseaz\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de flexibilitate pentru toate grupele musculare mari<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Fortificarea Cvadricepsului<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Seturi de cvadriceps (mini-genuflexiuni \/ genuflexiuni la perete)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de step-up<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Pres\u0103 pentru picioare, shuttle press (f\u0103r\u0103 mi\u0219care de s\u0103ritur\u0103)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de extensie a genunchiului (cu dinamometru, aparat sau sac de greut\u0103\u021bi)<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Fortificarea Ischiogambierilor<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de hamstring curl<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Ridicarea piciorului drept \u00een spate cu band\u0103 de rezisten\u021b\u0103 sau coard\u0103 sportiv\u0103 (resistive back SLR)<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4,\"translatedWithWPMLTM\":\"1\"} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Fortificarea Altelor Grupe Musculare<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Adduc\u021bie\/abduc\u021bie de \u0219old: SLR \u00een decubit lateral sau cu aparat<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Ridicarea c\u0103lc\u00e2iului \u00een picioare: se progreseaz\u0103 de la ambele picioare la un singur picior<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Pres\u0103 pentru gambe rezistent\u0103 \u00een pozi\u021bie \u0219ez\u00e2nd\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii \u00een toate direc\u021biile cu aparatul multi-hip (cu pozi\u021bionarea proximal\u0103 a pernu\u021bei)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cen \u00eenot, doar flutter kick (lovitur\u0103 de picior drept)<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Antrenament Neuromuscular<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Wobble board, rocker board<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Statul pe un picior (cu sau f\u0103r\u0103 echipament)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii pe slide board<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Exerci\u021bii Cardiopulmonare<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Biciclet\u0103, eliptic, Stairmaster<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Flutter kick \u00een piscin\u0103 (\u00eencep\u00e2nd cu s\u0103pt\u0103m\u00e2na a 12-a)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Cu acordul chirurgului \u0219i dac\u0103 sunt \u00eendeplinite urm\u0103toarele criterii, se poate \u00eencepe alergarea pe suprafa\u021b\u0103 plan\u0103 (pe band\u0103 de alergare sau \u00eentr-o zon\u0103 protejat\u0103):<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Indicele Cvadricepsului (QI) \u226580%<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Absen\u021ba oric\u0103rui epan\u0219ament articular (efuziune)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Amplitudine complet\u0103 de mi\u0219care<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Dac\u0103 aceste criterii nu sunt \u00eendeplinite, alergarea pe suprafa\u021b\u0103 plan\u0103\u00a0<strong>trebuie am\u00e2nat\u0103 pentru Faza 5<\/strong>.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Criterii de Trecere la Faza 5 (\u226520 S\u0103pt\u0103m\u00e2ni Postoperatoriu)<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Amplitudine complet\u0103 de mi\u0219care<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Epan\u0219ament articular \u0219i durere minime<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>For\u021b\u0103 \u0219i control muscular func\u021bional \u00een activit\u0103\u021bile zilnice (QI \u226580%, m\u0103surat cu LSI)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>S\u0103 fi trecut cel pu\u021bin 20 de s\u0103pt\u0103m\u00e2ni de la opera\u021bie<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 5: S\u0103pt\u0103m\u00e2nile 20\u201330<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:paragraph --><\/p>\n<p><strong>Fortificare \u0219i Control<\/strong><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\">Obiective<\/h3>\n<p><!-- \/wp:heading --><!-- wp:list {\"ordered\":true} --><\/p>\n<ol class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Men\u021binerea amplitudinii complete de mi\u0219care a articula\u021biei (ROM)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a alerga f\u0103r\u0103 durere \u0219i umfl\u0103tur\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a s\u0103ri f\u0103r\u0103 durere, umfl\u0103tur\u0103 sau cedare (giving way)<\/li>\n<p><!-- \/wp:list-item --><\/ol>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Fortificare<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Extensie de genunchi \u00een lan\u021b deschis (OKC knee extension)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de genuflexiuni (squat)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Pres\u0103 pentru picioare<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Hamstring curl<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de step-up \/ step-down<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Shuttle press<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii cu rezisten\u021b\u0103 cu coard\u0103 sportiv\u0103 (sports cord)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Genuflexiuni la perete<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Progresia la genuflexiuni pe un singur picior<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Exerci\u021bii de Agilitate<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>S\u0103rituri pe ambele picioare \u2192 progresia la s\u0103rituri pe un singur picior pe m\u0103sur\u0103 ce este tolerat<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Antrenament Neuromuscular<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii cu wobble board, rocker board, roller board<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Antrenament de perturbare, sisteme de testare asistate de dispozitive, exerci\u021bii de echilibru pe diferite suprafe\u021be<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Exerci\u021bii Cardiopulmonare<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Dup\u0103 aprobarea chirurgului \u0219i dac\u0103 sunt \u00eendeplinite urm\u0103toarele criterii, se poate \u00eencepe un program de alergare pe band\u0103 sau \u00eentr-o zon\u0103 protejat\u0103:<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>QI \u226580%<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Doar epan\u0219ament articular minim (trace effusion)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Amplitudine complet\u0103 de mi\u0219care<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Mi\u0219c\u0103rile de t\u0103iere (cutting) sau de pivotare sunt strict interzise.<\/strong><\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Toate celelalte echipamente cardiopulmonare pot fi utilizate.<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Criterii de Trecere la Faza 6 (\u226530 S\u0103pt\u0103m\u00e2ni Postoperatoriu)<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Capacitatea de a alerga f\u0103r\u0103 cre\u0219tere a durerii sau umfl\u0103turii<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a efectua exerci\u021bii neuromusculare \u0219i de fortificare f\u0103r\u0103 dificultate<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a men\u021bine echilibrul pe un singur picior timp de 60 de secunde<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Atingerea unei \u00een\u0103l\u021bimi de s\u0103ritur\u0103 de 50% pe piciorul operat (test de s\u0103ritur\u0103 cu ortez\u0103)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Completarea testelor func\u021bionale de s\u0103ritur\u0103 \u0219i ob\u021binerea aprob\u0103rii chirurgului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Indicele Cvadricepsului (QI) \u226580%<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 6: S\u0103pt\u0103m\u00e2nile 30\u201336<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:paragraph --><\/p>\n<p><strong>Antrenament de Nivel Avansat<\/strong><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Obiective<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list {\"ordered\":true} --><\/p>\n<ol class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Capacitatea de a efectua modele de alergare la 75% din vitez\u0103 f\u0103r\u0103 dificultate<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a efectua exerci\u021bii de s\u0103ritur\u0103 f\u0103r\u0103 probleme<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Atingerea a cel pu\u021bin 85% din valorile piciorului s\u0103n\u0103tos la testele de s\u0103ritur\u0103<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Testele de s\u0103ritur\u0103 Cincinnati:<!-- wp:list -->\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>S\u0103ritur\u0103 pe un singur picior pentru distan\u021b\u0103 (single-leg hop for distance)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>S\u0103ritur\u0103 tripl\u0103 pentru distan\u021b\u0103 (triple-hop for distance)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>S\u0103ritur\u0103 \u00eencruci\u0219at\u0103 pentru distan\u021b\u0103 (crossover hop for distance)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>S\u0103ritur\u0103 cronometrat\u0103 pe 6 metri (6-meter timed hop)<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><\/li>\n<p><!-- \/wp:list-item --><\/ol>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Fortificare<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de genuflexiuni (squat)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de fandare (lunge)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii pliometrice<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Exerci\u021bii de Agilitate<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Pa\u0219i laterali (shuffling)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>S\u0103rituri pe un picior\/dou\u0103 picioare (hopping)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Carioca (alergare cu pa\u0219i \u00eencruci\u0219a\u021bi)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>S\u0103rituri verticale (vertical jumps)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Modele de alergare la 50\u201375% din vitez\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii specifice ramurii sportive pot fi \u00eencepute cu un efort de 50\u201375%<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Antrenament Neuromuscular<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii cu wobble board, rocker board, roller board<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Antrenament de perturbare, sisteme de testare asistate de dispozitive<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de echilibru pe diferite suprafe\u021be<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Exerci\u021bii Cardiopulmonare<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Antrenamente de alergare<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Alte exerci\u021bii cardiopulmonare<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Criterii de Trecere la Faza 7 (\u226536 S\u0103pt\u0103m\u00e2ni Postoperatoriu)<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Absen\u021ba durerii sau instabilit\u0103\u021bii \u00een timpul s\u0103riturii verticale maxime<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Atingerea a \u226585% din valorile piciorului s\u0103n\u0103tos la testele de s\u0103ritur\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a alerga la 85% din vitez\u0103 f\u0103r\u0103 dificultate<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Scorul\u00a0<strong>\u00centreb\u0103rii #10 IKDC (Evaluarea Global\u0103 a Func\u021biei Genunchiului)<\/strong>\u00a0s\u0103 fie \u22658<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Demonstrarea unei func\u021bii de \u226585% la testele func\u021bionale de s\u0103ritur\u0103 \u0219i ob\u021binerea aprob\u0103rii chirurgului<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Atingerea unui nivel de Indice al Cvadricepsului (QI) \u226585%<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>Faza 7: S\u0103pt\u0103m\u00e2nile 36\u201352 &#8211; <\/strong><strong>Revenirea la Sport (Return-to-Sport)<\/strong><\/h2>\n<p><!-- \/wp:heading --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Obiective<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list {\"ordered\":true} --><\/p>\n<ol class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>For\u021ba cvadricepsului s\u0103 fie \u226590% fa\u021b\u0103 de piciorul s\u0103n\u0103tos<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Ob\u021binerea unui succes de \u226590% la testele de s\u0103ritur\u0103 fa\u021b\u0103 de piciorul s\u0103n\u0103tos<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Capacitatea de a efectua antrenamente specifice ramurii sportive f\u0103r\u0103 durere, umfl\u0103tur\u0103 \u0219i dificultate<\/li>\n<p><!-- \/wp:list-item --><\/ol>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Fortificare<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de genuflexiuni (squat)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de fandare (lunge)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii pliometrice<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":4} --><\/p>\n<h4 class=\"wp-block-heading\"><strong>Activit\u0103\u021bi Specifice Sportului<\/strong><\/h4>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Programe de antrenament pe intervale<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Modele de alergare \u00een fotbal<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de sprint<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de schimbare a direc\u021biei<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Exerci\u021bii de pivot \u0219i drive-in \u00een baschet<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u0218ut \u0219i pas (kicking) \u00een fotbal<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Smash (spiking) \u00een volei<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Analiz tehnic\u0103\/biomecanic\u0103: trebuie efectuat\u0103 \u00eempreun\u0103 cu antrenorul \u0219i echipa de medicin\u0103 sportiv\u0103<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3,\"translatedWithWPMLTM\":\"1\"} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Evaluare pentru Revenirea la Sport<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li><strong>Test de echilibru:<\/strong>\u00a0Capacitatea de a men\u021bine echilibrul pe un singur picior timp de 60 de secunde (pentru ambele picioare, f\u0103r\u0103 a atinge solul)<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Genuflexiune pe un picior:<\/strong>\u00a0Capacitatea de a cobor\u00ee p\u00e2n\u0103 la 60\u00b0 flexie; f\u0103r\u0103 rota\u021bie intern\u0103 la \u0219old sau valg la genunchi<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Teste de s\u0103ritur\u0103:<\/strong>\u00a0\u226595% din piciorul s\u0103n\u0103tos la s\u0103ritura pe un singur picior pentru distan\u021b\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li><strong>Indicele Cvadricepsului (QI):<\/strong>\u00a0\u226590%<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading {\"level\":3} --><\/p>\n<h3 class=\"wp-block-heading\"><strong>Criterii de Revenire la Antrenamentul Echipei<\/strong><\/h3>\n<p><!-- \/wp:heading --><!-- wp:list --><\/p>\n<ul class=\"wp-block-list\"><!-- wp:list-item --><\/p>\n<li>Absen\u021ba pl\u00e2ngerilor func\u021bionale<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>\u00cencredere \u00een timpul alerg\u0103rii la vitez\u0103 maxim\u0103, schimb\u0103rii direc\u021biei \u0219i s\u0103riturilor<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Atingerea a \u226590% din valorile piciorului s\u0103n\u0103tos la testele de s\u0103ritur\u0103<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Indicele Cvadricepsului (QI) \u226590%<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Scorul\u00a0<strong>\u00centreb\u0103rii #10 IKDC (Evaluarea Global\u0103 a Func\u021biei Genunchiului)<\/strong>\u00a0s\u0103 fie \u22659<\/li>\n<p><!-- \/wp:list-item --><\/p>\n<p><!-- wp:list-item --><\/p>\n<li>Acordul chirurgului care a efectuat interven\u021bia pentru revenirea la sport<\/li>\n<p><!-- \/wp:list-item --><\/ul>\n<p><!-- \/wp:list --><!-- wp:heading --><\/p>\n<h2 class=\"wp-block-heading\"><strong>\u00centreb\u0103ri Frecvente (FAQ) Despre Interven\u021bia de Reparare a Ligamentului \u00cencruci\u0219at Anterior<\/strong><\/h2>\n<p><!-- \/wp:heading --><\/p>\n<div class=\"wp-block-rank-math-faq-block\">\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">Ce este repararea ligamentului \u00eencruci\u0219at anterior?<\/h3>\n<div class=\"rank-math-answer\">Repararea ligamentului \u00eencruci\u0219at anterior este procedura de reata\u0219are a ligamentului rupt la locul s\u0103u anatomic de inser\u021bie, cu p\u0103strarea \u021besutului propriu.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">Care este diferen\u021ba dintre repararea ligamentului \u00eencruci\u0219at anterior \u0219i reconstruc\u021bie?<\/h3>\n<div class=\"rank-math-answer\">\u00cen reparare, ligamentul existent este p\u0103strat, \u00een timp ce \u00een reconstruc\u021bie se creeaz\u0103 un nou ligament folosind o gref\u0103 de tendon \u00een locul ligamentului rupt.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">Poate fi reparat\u0103 orice leziune a ligamentului \u00eencruci\u0219at anterior?<\/h3>\n<div class=\"rank-math-answer\">Nu. Repararea este adecvat\u0103 doar \u00een cazurile de leziuni recente la pacien\u021bi tineri \u0219i cu rupturi aproape de inser\u021bia femural\u0103.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">C\u00e2t dureaz\u0103 repararea ligamentului \u00eencruci\u0219at anterior?<\/h3>\n<div class=\"rank-math-answer\">Durata interven\u021biei chirurgicale variaz\u0103, de obicei, \u00eentre 45 \u0219i 60 de minute.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">C\u00e2nd pot merge dup\u0103 opera\u021bie?<\/h3>\n<div class=\"rank-math-answer\">\u00cenc\u0103rcarea par\u021bial\u0103 \u00eencepe de obicei imediat dup\u0103 opera\u021bie, iar \u00eenc\u0103rcarea complet\u0103 are loc \u00een aproximativ 6 s\u0103pt\u0103m\u00e2ni.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">C\u00e2nd pot reveni la sport dup\u0103 repararea ligamentului \u00eencruci\u0219at anterior?<\/h3>\n<div class=\"rank-math-answer\">Revenirea la sport este, de obicei, posibil\u0103 \u00een 6\u20139 luni, \u00een func\u021bie de ramura sportiv\u0103 \u0219i de ritmul de recuperare.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">Exist\u0103 riscul unei re-rupturi dup\u0103 opera\u021bie?<\/h3>\n<div class=\"rank-math-answer\">Da, \u00een special revenirea la sporturi de mare intensitate prea devreme sau suferirea unei noi traume cre\u0219te riscul.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">Apare rigiditate \u00een genunchi dup\u0103 repararea ligamentului \u00eencruci\u0219at anterior?<\/h3>\n<div class=\"rank-math-answer\">Dac\u0103 reabilitarea este incomplet\u0103, se poate dezvolta rigiditate la nivelul genunchiului (<a href=\"https:\/\/www.utkuerdemozer.com\/ro\/ce-este-artrofibroza-si-cum-se-trateaza\/\">artrofibroz\u0103<\/a>). Exerci\u021biile regulate reduc acest risc.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">\u00cen ce situa\u021bii se prefer\u0103 reconstruc\u021bia \u00een locul repar\u0103rii?<\/h3>\n<div class=\"rank-math-answer\">Reconstruc\u021bia este preferat\u0103 \u00een cazurile \u00een care ligamentul este complet rupt, capsula sa este deteriorat\u0103 sau ruptura se afl\u0103 \u00een por\u021biunea mijlocie.<\/div>\n<\/div>\n<div class=\"rank-math-faq-item\">\n<h3 class=\"rank-math-question\">Care este rata de succes a repar\u0103rii ligamentului \u00eencruci\u0219at anterior?<\/h3>\n<div class=\"rank-math-answer\">Rata de succes la pacien\u021bii potrivi\u021bi este raportat\u0103 \u00een literatur\u0103 \u00eentre 70\u201390%.<\/div>\n<\/div>\n<\/div>\n<p><!-- \/wp:heading --><\/p>\n\n<!-- wp:paragraph -->\n<p><\/p>\n<!-- \/wp:paragraph -->","protected":false},"excerpt":{"rendered":"<p>Cum se realizeaz\u0103 interven\u021bia chirurgical\u0103 de reparare a ligamentului \u00eencruci\u0219at anterior? Localizarea ligamentului \u00eencruci\u0219at anterior \u0219i importan\u021ba sa biomecanic\u0103 pentru articula\u021bia genunchiului fac ca interven\u021bia chirurgical\u0103 s\u0103 fie indispensabil\u0103 \u00een cazul leziunilor acestuia.<\/p>\n","protected":false},"author":1,"featured_media":27484,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89,137],"tags":[],"class_list":["post-29131","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-chirurgia-genunchiului","category-chirurgie-sportiva-si-artroscopie"],"_links":{"self":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts\/29131","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/comments?post=29131"}],"version-history":[{"count":2,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts\/29131\/revisions"}],"predecessor-version":[{"id":32974,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts\/29131\/revisions\/32974"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/media\/27484"}],"wp:attachment":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/media?parent=29131"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/categories?post=29131"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/tags?post=29131"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}