UTILIZATION OF HYDROCORTISONE ACETATE PHONOPHORESIS IN COMBINATION WITH THERAPEUTIC EXERCISE IN THE REHABILITATION MANAGEMENT OF FUNCTIONAL LIMITATIONS CAUSED BY KNEE ARTHROFIBROSIS.

Arthrofibrosis is a joint pathology during which excess collagen is produced resulting in movement limitation, inflammation and pain. Itis caused by repeated injuries or surgical interventions, which is frequently managed by using certain medications such as glucocorticosteroids.The goal of our research was to study the effect of therapeutic exercise and hydrocortisone acetate (HA) phonophoresis combination therapy on the management of the rehabilitation process of knee joint functional limitations caused by arthrofibrosis and to establish the optimal parameters of ultrasound needed to achieve therapeutic effect.25 male patients between the ages of 18 and 50 (mean age 39±3.4 years) with moderate contracture of the knee and limitation of knee flexion, which varied between 70° and 90° participated in the randomized controlled experimental research. In addition, modified Cincinnati questionnaire scale (MCSc) was used. The following 3-week rehabilitation programs were developed: : I - the control group was assigned an individual home exercise program (HEP) 5 times a week; the experimental group II was assigned a treatment program which included the same exercise in addition to phonophoresis with 10% hydrocortisone gel (mixed ultrasound gel), duration - 10 minutes, frequency - 1.0 MHz, duty cycle - 50% (Pulsed), 1.0 W/cm2 high intensity ultrasound (HEP+PWHi); the experimental group III was assigned an almost identical program to the group II with the difference being 100% (Constant) duty cycle of the ultrasound (HEP+CWHi). As for groups IV and V - these groups were assigned the same home exercise programs alongside 10 minutes of low intensity 0.5 W/cm2, 1.0MHz, 50% (HEP+PWLi) and 100% (HEP+CWLi) ultrasound accordingly with 10% hydrocortisone gel, 15 procedures total.The results of the study revealed that using phonophoresis with high concentration hydrocortisone acetate that's mixed with ultrasound gel alongside therapeutic exercise in the treatment and rehabilitation of moderate post-traumatic or post-operative extension contracture of the knee caused by arthrofibrosis can be successful, which could enable us to achieve 40-50% of progress regarding knee flexion and functioning in 3 weeks in case 1.0 Mhz, 1 W/cm2, 50% pulsed ultrasound is utilized during 10 minutes, 5 times per week.