Harvard Vanguard Orthopedics and Sports Medicine, 291 Independence Drive, Chestnut Hill, MA 02467, USA.
Am J Sports Med. 2009 Nov;37 Suppl 1:167S-76S. doi: 10.1177/0363546509351650. Epub 2009 Oct 27.
Articular cartilage injury in the athlete's knee presents a difficult clinical challenge. Despite the importance of returning injured athletes to sports, information is limited on whether full sports participation can be successfully achieved after articular cartilage repair in the knee.
Systematic analysis of athletic participation after articular cartilage repair will demonstrate the efficacy of joint surface restoration in high-demand patients and help to optimize outcomes in athletes with articular cartilage injury of the knee.
Systematic review.
A comprehensive literature review of original studies was performed to provide information about athletic participation after articular cartilage repair. The athlete's ability to perform sports postoperatively was assessed by activity outcome scores, rate of return to sport, timing of the return, level of postoperative sports participation, and the continuation of athletic activity over time.
Twenty studies describing 1363 patients were included in the review, with an average follow-up of 42 months. Return to sports was possible in 73% overall, with highest return rates after osteochondral autograft transplantation. Time to return to sports varied between 7 and 18 months, depending on the cartilage repair technique. Initial return to sports at the preinjury level was possible in 68% and did not significantly vary between surgical techniques. Continued sports participation at the preinjury level was possible in 65%, with the best durability after autologous chondrocyte transplantation. Several factors affected the ability to return to sport: athlete's age, preoperative duration of symptoms, level of play, lesion size, and repair tissue morphology.
Articular cartilage repair in the athletic population allows for a high rate of return to sports, often at the preinjury level. Return to sports participation is influenced by several independent factors. The findings provide pertinent information that is helpful for the clinical decision-making process and for the management of the athlete's postoperative expectations.
运动员膝关节的关节软骨损伤是一个具有挑战性的临床难题。尽管让受伤运动员重返运动至关重要，但关于膝关节关节软骨修复后是否能成功恢复全面运动，相关信息有限。
对关节软骨修复后的运动参与情况进行系统分析，将证明关节表面修复在高需求患者中的疗效，并有助于优化膝关节关节软骨损伤运动员的治疗效果。
系统回顾。
对原始研究进行全面文献回顾，提供关节软骨修复后运动参与情况的信息。通过活动结果评分、重返运动率、重返时间、术后运动参与水平以及随时间推移运动活动的持续情况，评估运动员术后进行运动的能力。
共纳入 20 项研究，涉及 1363 例患者，平均随访 42 个月。总体上有 73%的患者能够重返运动，其中骨软骨自体移植的恢复率最高。根据软骨修复技术的不同，重返运动的时间在 7 至 18 个月之间不等。68%的患者能够在术前水平上恢复初始运动，且不同手术技术之间差异无统计学意义。65%的患者能够继续保持术前运动水平，其中自体软骨细胞移植的耐久性最好。有几个因素会影响重返运动的能力：运动员年龄、术前症状持续时间、运动水平、损伤大小和修复组织形态。
在运动人群中进行关节软骨修复可使患者获得较高的运动恢复率，通常可恢复到术前水平。重返运动参与受多个独立因素影响。研究结果提供了相关信息，有助于临床决策过程和运动员术后预期的管理。
