Department of Trauma and Orthopaedics, Ipswich Hospital NHS Trust, Health Road, Ipswich, Suffolk, England.
Arthroscopy. 2013 Mar;29(3):556-65. doi: 10.1016/j.arthro.2012.09.005. Epub 2013 Jan 12.
The aim of this meta-analysis was to compare the risk of stiffness between early and delayed anterior cruciate ligament (ACL) surgery in studies that use a modern accelerated rehabilitation protocol.
Medline, Embase, and the Cochrane library were searched for studies that compared outcomes for early and delayed ACL reconstruction with a modern accelerated rehabilitation protocol. Risk ratios for stiffness were pooled using random effects meta-analysis.
A total of 8 studies were included in this review. The 3 randomized trials found no difference in the risk of postoperative stiffness at cutoff points of <2, <3, and <10 weeks between early surgery and delayed surgery. An analysis of the 7 studies whose outcomes could be pooled revealed no significant increase in risk of adverse outcomes with early surgery using a variety of cutoff points (1, 2, 10, 12, and 20 weeks). Sensitivity analysis of individual outcomes failed to show any significant difference between early and delayed surgery with respect to arthrofibrosis, stiffness, range of motion deficits, extension deficits, and flexion deficits.
If a modern surgical technique and an accelerated rehabilitation protocol are used, there is no increased risk of knee stiffness if an ACL reconstruction is performed as early as 1 week after injury.
Level II, meta-analysis of Level I and II studies.
本荟萃分析旨在比较使用现代加速康复方案的研究中，早期和延迟前交叉韧带（ACL）手术的僵硬风险。
检索 Medline、Embase 和 Cochrane 图书馆，以比较使用现代加速康复方案的早期和延迟 ACL 重建的结果。使用随机效应荟萃分析汇总僵硬风险比。
本综述共纳入 8 项研究。3 项随机试验发现在 <2、<3 和 <10 周的时间点，早期手术和延迟手术之间的术后僵硬风险没有差异。对可进行汇总的 7 项研究的分析表明，使用各种时间点（1、2、10、12 和 20 周）进行早期手术并不会增加不良结果的风险。对个别结果的敏感性分析表明，早期和延迟手术在关节纤维化、僵硬、运动范围缺陷、伸展缺陷和弯曲缺陷方面没有显著差异。
如果使用现代手术技术和加速康复方案，如果在受伤后 1 周内进行 ACL 重建，膝关节僵硬的风险不会增加。
II 级，I 级和 II 级研究的荟萃分析。
