ASSESSMENT OF RISKS OF DEVOLEPMENT OF ARTHROFIBROSIS AND PREVENTION OF KNEE EXTENSION DEFICIT SUBSEQUENT TO AN ANTERIOR CRUTIATE LIGAMENT RECONSTRUCTION.

The goal of our research was to study the impact of various risk-factors on the development of arthrofibrosis in patients with knee extension restriction on an early stage. The aforementioned research was carried out in the Sports Medicine and Rehabilitation Clinical Center and First University Clinic of Tbilisi State Medical University during the 2016-2020 y.y. and it is based upon the findings derived from the retrospective analysis of 38 male patient cases (mean age 25.42±5.85) with undergone ACL reconstruction and the assessment of importance of the impact of various risk-factors on developing a clinically confirmed knee arthrofibrosis. In order to identify the important role of pain as a risk factor in the development of knee arthrofibrosis, the patients were divided into 2 groups (A and B). Group A consisted of 17 patients with confirmed arthrofibrosis while group B consisted of 21 patients whose rehabilitation process resulted in complete eradication of knee join extension deficit. During the comparison of data on the average level of pain between the patients from groups A and B a reliable difference was identified (p=0.048). The presence of pain is in direct correlation with arthrofibrosis development process in the knee (R= -0.65), therefore, together with joint ROM (Range of motion) restriction, it can be considered as one of the most noteworthy preconditions among the risk-factors that were part of our research. To increase the efficiency of the rehabilitation process after a ACL reconstruction procedure when knee extension deficit alongside with pain is present, according to the Creaky Joints Pain - CJP scale ≥4, it is most appropriate to incorporate more aggressive interventions into the rehabilitation program and, at the same time, to utilize pain management methods actively during the early stage (after 2 weeks) in order to eradicate knee extension restriction and prevent arthrofibrosis.