{"id":6570,"date":"2021-03-22T18:56:57","date_gmt":"2021-03-22T18:56:57","guid":{"rendered":"http:\/\/www.orthes.cz\/?page_id=6570"},"modified":"2021-05-21T18:42:20","modified_gmt":"2021-05-21T18:42:20","slug":"rekonstrukce-zkrizenych-vazu-v-kolene","status":"publish","type":"page","link":"https:\/\/www.orthes.cz\/index.php\/rekonstrukce-zkrizenych-vazu-v-kolene\/","title":{"rendered":"Rekonstrukce zk\u0159\u00ed\u017een\u00fdch vaz\u016f v kolen\u011b"},"content":{"rendered":"[vc_row type=“full_width_background“ full_screen_row_position=“middle“ column_margin=“default“ column_direction=“default“ column_direction_tablet=“default“ column_direction_phone=“default“ bg_image=“6576″ bg_position=“center center“ bg_repeat=“no-repeat“ scene_position=“center“ text_color=“dark“ text_align=“left“ row_border_radius=“none“ row_border_radius_applies=“bg“ color_overlay=“#ffffff“ overlay_strength=“0.5″ gradient_direction=“left_to_right“ shape_divider_position=“bottom“ bg_image_animation=“none“ shape_type=““][vc_column column_padding=“no-extra-padding“ column_padding_tablet=“inherit“ column_padding_phone=“inherit“ column_padding_position=“all“ background_color_opacity=“1″ background_hover_color_opacity=“1″ column_shadow=“none“ column_border_radius=“none“ column_link_target=“_self“ gradient_direction=“left_to_right“ overlay_strength=“0.3″ width=“1\/1″ tablet_width_inherit=“default“ tablet_text_alignment=“default“ phone_text_alignment=“default“ column_border_width=“none“ column_border_style=“solid“ bg_image_animation=“none“][divider line_type=“No Line“ custom_height=“650″][\/vc_column][\/vc_row][vc_row type=“in_container“ full_screen_row_position=“middle“ column_margin=“default“ column_direction=“default“ column_direction_tablet=“default“ column_direction_phone=“default“ scene_position=“center“ top_padding=“5%“ text_color=“dark“ text_align=“left“ row_border_radius=“none“ row_border_radius_applies=“bg“ overlay_strength=“0.3″ gradient_direction=“left_to_right“ shape_divider_position=“bottom“ bg_image_animation=“none“ shape_type=““][vc_column column_padding=“no-extra-padding“ column_padding_tablet=“inherit“ column_padding_phone=“inherit“ column_padding_position=“all“ background_color_opacity=“1″ background_hover_color_opacity=“1″ column_shadow=“none“ column_border_radius=“none“ column_link_target=“_self“ gradient_direction=“left_to_right“ overlay_strength=“0.3″ width=“1\/1″ tablet_width_inherit=“default“ tablet_text_alignment=“default“ phone_text_alignment=“default“ column_border_width=“none“ column_border_style=“solid“ bg_image_animation=“none“][vc_column_text]\n

Rekonstrukce zk\u0159\u00ed\u017een\u00fdch vaz\u016f v kolen\u011b<\/h2>\n

Funkc\u00ed zk\u0159\u00ed\u017een\u00e9ho vazu je p\u0159edchoz\u00ed stabilita kolene. K poran\u011bn\u00ed doch\u00e1z\u00ed ve v\u00edce ne\u017e 90% p\u0159\u00edpad\u016f na p\u0159edn\u00edm zk\u0159\u00ed\u017een\u00e9m vazu (ACL). Zran\u011bn\u00ed tohoto vazu jsou velmi \u010dast\u00e1 u kontaktn\u00edch sport\u016f jako je kopan\u00e1, h\u00e1zen\u00e1 nebo ko\u0161\u00edkov\u00e1, \u010dast\u00e1 jsou i p\u0159i ly\u017eov\u00e1n\u00ed. Zran\u011bn\u00ed je oby\u010dejn\u011b zp\u016fsobeno kombinac\u00ed p\u0159\u00edli\u0161n\u00e9ho prota\u017een\u00ed a vyto\u010den\u00ed kolene. Typicky zran\u011bn\u00fd usly\u0161\u00ed nebo uc\u00edt\u00ed prasknut\u00ed a bude m\u00edt siln\u00fd n\u00e1por bolesti, nestabilitu a otok \u2013 zp\u016fsoben\u00fd krevn\u00ed n\u00e1pln\u00ed kloubu.<\/p>\n

Koleno je nutno vy\u0161et\u0159it a zjistit tak\u00e9 p\u0159idru\u017een\u00e1 poran\u011bn\u00ed (nap\u0159. menisk\u016f \u010di jin\u00fdch vaz\u016f), a taktiku l\u00e9\u010dby pak stanovit individu\u00e1ln\u011b. Pokud se jedn\u00e1 o izolovan\u00e9 poran\u011bn\u00ed ACL, je mo\u017eno postupovat v z\u00e1sad\u011b dv\u011bma zp\u016fsoby :<\/p>\n

    \n
  1. Opera\u010dn\u00ed \u2013 n\u00e1hrada vazu viz. n\u00ed\u017ee<\/li>\n
  2. Konzervativn\u00ed \u2013 c\u00edlenou rehabilitac\u00ed rozvoj kompenza\u010dn\u00edch stabiliz\u00e1tor\u016f kolene<\/li>\n<\/ol>\n

    Rozhodnut\u00ed provede l\u00e9ka\u0159 dle zhodnocen\u00e9ho stupn\u011b nestability a t\u00e9\u017e aktivity a v\u011bku pacienta.<\/p>\n

    B\u011b\u017en\u00e1 denn\u00ed z\u00e1t\u011b\u017e a n\u011bkter\u00e9 sporty mohou b\u00fdt docela dob\u0159e prov\u00e1d\u011bny i bez zk\u0159\u00ed\u017een\u00e9ho vazu. Jsou to „pohyb dop\u0159edu sm\u011b\u0159uj\u00edc\u00ed“ sporty jako cyklistika, lehk\u00fd b\u011bh a plav\u00e1n\u00ed. Silov\u00e9 sporty, sporty, ve kter\u00fdch se \u010dasto m\u011bn\u00ed sm\u011br pohybu, nejsou p\u0159i nestabilit\u011b doporu\u010dov\u00e1ny. Doch\u00e1z\u00ed ke zv\u00fd\u0161en\u00e9mu pohybu v kolen\u011b do r\u016fzn\u00fdch stran, t\u00edm doch\u00e1z\u00ed ke zv\u00fd\u0161en\u00e9mu tlaku na chrupavku, co\u017e postupn\u011b vede k vzniku trhlinek na chrupavce, po\u0161kozen\u00ed obou menisk\u016f a dal\u0161\u00edm po\u0161kozen\u00edm kloubn\u00edho povrchu. Postupem \u010dasu tyto defekty vedou k artr\u00f3ze.<\/p>\n

    Mo\u017enosti l\u00e9\u010dby:<\/strong> L\u00e9\u010dba poran\u011bn\u00ed ACL prod\u011blala v posledn\u00edch deseti letech mnoho zm\u011bn. V dne\u0161n\u00ed dob\u011b maj\u00ed sportovci v\u00edce ne\u017e 90% \u0161anci na pln\u00e9 uzdraven\u00ed.<\/p>\n

    Neopera\u010dn\u00ed l\u00e9\u010dba<\/h2>\n

    Konservativn\u00ed l\u00e9\u010dba je doporu\u010dena v p\u0159\u00edpadech, kde je koleno st\u00e1le v akceptovan\u00fdch limitech stability. Neopera\u010dn\u00ed l\u00e9\u010dba je rovn\u011b\u017e doporu\u010dena u pacient\u016f, kte\u0159\u00ed uprav\u00ed sv\u00e9 aktivity k m\u00e9n\u011b n\u00e1ro\u010dn\u00fdm sport\u016fm. V t\u011bchto p\u0159\u00edpadech je t\u0159eba zah\u00e1jit okam\u017eit\u011b speci\u00e1ln\u00ed rehabilita\u010dn\u00ed program a pou\u017e\u00edvat speci\u00e1ln\u00ed kolenn\u00ed ort\u00e9zu b\u011bhem sportovn\u00ed aktivity.<\/p>\n

    Opera\u010dn\u00ed mo\u017enosti<\/h2>\n

    Operace zk\u0159\u00ed\u017een\u00fdch vaz\u016f je vysoce specializovan\u00fd v\u00fdkon a proto je t\u0159eba, aby byl prov\u00e1d\u011bn zku\u0161en\u00fdm operat\u00e9rem. Technologie se st\u00e1le vyv\u00edj\u00ed .<\/p>\n

    Rekonstrukce:<\/strong> Znamen\u00e1 vytvo\u0159en\u00ed nov\u00e9ho vazu pou\u017eit\u00edm vlastn\u00ed tk\u00e1n\u011b pacienta. Ka\u017ed\u00e1 z uveden\u00fdch metod m\u00e1 sv\u00e1 pro a proti, jsou i r\u016fzn\u00e9 mo\u017enosti kotven\u00ed \u0161t\u011bpu.<\/p>\n

    Dle m\u00edsta, odkud se \u0161t\u011bp odeb\u00edr\u00e1, je mo\u017eno pou\u017e\u00edt:<\/p>\n

    Autogenn\u00ed \u0161t\u011bp z vazu \u010d\u00e9\u0161ky<\/h2>\n

    Znamen\u00e1 to vz\u00edt prou\u017eek \u0161lachy zep\u0159edu pacientova vlastn\u00edho kolena. Je pova\u017eov\u00e1na za standard u rekonstrukce ACL.<\/p>\n

    Hamstringy – \u0161t\u011bp ze \u0161lachy ohyba\u010de kolenn\u00edho kloubu<\/h2>\n

    Pou\u017e\u00edv\u00e1me u n\u00e1s. V\u00fdhodu spat\u0159ujeme ve vy\u0161\u0161\u00ed mechanick\u00e9 pevnosti \u0161t\u011bpu, odb\u011br neoslabuje natahova\u010d kolene, je m\u00e9n\u011b bolestiv\u00fd a v neposledn\u00ed \u0159ad\u011b kosmeticky p\u0159\u00edzniv\u011bj\u0161\u00ed. Kotven\u00ed \u0161t\u011bpu pou\u017e\u00edv\u00e1me ze vst\u0159ebateln\u00e9ho materi\u00e1lu.<\/p>\n

    Poopera\u010dn\u00ed p\u00e9\u010de:<\/strong> Pacienti jsou hospitalizov\u00e1ni cca 4 dny, pot\u00e9 jsou propu\u0161t\u011bni dom\u016f. Cvi\u010den\u00ed s c\u00edlem obnoven\u00ed rozsahu pohybu a pos\u00edlen\u00ed sval\u016f za\u010d\u00edn\u00e1 v co nejkrat\u0161\u00edm \u010dase po operaci, po propu\u0161t\u011bn\u00ed pacienti doch\u00e1z\u00ed na cvi\u010den\u00ed ambulantn\u011b. Noha je rovn\u011b\u017e okam\u017eit\u011b zat\u011b\u017eovan\u00e1 p\u0159i ch\u016fzi, nejprve v\u0161ak s pomoc\u00ed berl\u00ed. Ch\u016fze bez berl\u00ed je mo\u017en\u00e1 po cca 3 t\u00fddnech. Jakmile pacient dos\u00e1hne pokr\u010den\u00ed v kolen\u011b na 100 stup\u0148\u016f, je vhodn\u00e1 j\u00edzda na rotopedu. J\u00edzda na kole a b\u011bh jsou mo\u017en\u00e9 nejd\u0159\u00edve po 3 m\u011bs\u00edc\u00edch. N\u00e1vrat k fyzicky n\u00e1ro\u010dn\u00fdm sport\u016fm je mo\u017en\u00fd po 6 m\u011bs\u00edc\u00edch, ale pouze v p\u0159\u00edpad\u011b, \u017ee bylo znovu z\u00edsk\u00e1no 90-95% svalov\u00e9 hmoty.<\/p>\n

    Progn\u00f3za:<\/strong> Rekonstrukce zk\u0159\u00ed\u017een\u00fdch vaz\u016f v kolen\u011b je vysoce \u00fasp\u011b\u0161n\u00e1 operace. 90-95% pacient\u016f m\u016f\u017ee P\u0159edpokl\u00e1dat, \u017ee se p\u0159i kvalitn\u00ed rehabilitaci m\u016f\u017ee za 6 m\u011bs\u00edc\u016f vr\u00e1tit k aktivn\u00edmu zp\u016fsobu \u017eivota.[\/vc_column_text][\/vc_column][\/vc_row]\n","protected":false},"excerpt":{"rendered":"

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