Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A..
Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
Arthroscopy. 2014 Jun;30(6):731-8. doi: 10.1016/j.arthro.2014.02.034. Epub 2014 Apr 3.
This study aimed to determine practice patterns for National Football League (NFL) and National Collegiate Athletic Association (NCAA) Division I football team orthopaedic surgeons regarding management of anterior cruciate ligament (ACL) tears in elite, young, and middle-aged recreational athletes.
Two hundred sixty-seven NFL and NCAA Division I team orthopaedic surgeons were surveyed through an online survey. A 9-question survey assessed surgeon experience, graft choice, femoral tunnel drilling access, number of graft bundles, and rehabilitation after ACL reconstruction.
One hundred thirty-seven team orthopaedic surgeons (51%) responded (mean experience 16.75 ± 8.7 years). Surgeons performed 82 ± 50 ACL reconstructions in 2012. One hundred eighteen surgeons (86%) would use bone-patellar tendon-bone (BPTB) autografts to treat their starting running backs. Ninety (67%) surgeons drill the femoral tunnel through an accessory anteromedial portal (26% through a transtibial portal). Only 1 surgeon prefers a double-bundle to a single-bundle reconstruction. Seventy-seven (55.8%) surgeons recommend waiting at least 6 months before return to sport, whereas 17 (12.3%) wait at least 9 months. No surgeon recommends waiting 12 months or more before return to sport. Eighty-eight (64%) surgeons do not recommend a brace for their starting running backs during sport once they return to play.
BPTB is the most frequently used graft for ACL reconstruction by NFL and NCAA Division I team physicians in their elite-level running backs. Nearly all surgeons always use a single-bundle technique, and most do not recommend a brace on return to sport in running backs. Return to sport most commonly occurs at least 6 months postoperatively, with some surgeons requiring a normal examination and normal return-to-sport testing (single leg hop).
本研究旨在确定美国国家橄榄球联盟（NFL）和美国全国大学体育协会（NCAA）一级足球团队骨科医生对精英、年轻和中年娱乐运动员前交叉韧带（ACL）撕裂的管理的实践模式。
通过在线调查对 267 名 NFL 和 NCAA 一级团队骨科医生进行了调查。一个 9 个问题的调查评估了外科医生的经验、移植物选择、股骨隧道钻取通道、移植物束的数量以及 ACL 重建后的康复情况。
137 名团队骨科医生（51%）做出了回应（平均经验 16.75 ± 8.7 年）。2012 年，外科医生进行了 82 ± 50 次 ACL 重建。118 名外科医生（86%）会使用骨-髌腱-骨（BPTB）自体移植物来治疗他们的首发跑卫。90 名（67%）外科医生通过辅助前内侧入路（26%通过经胫骨入路）钻取股骨隧道。只有 1 名外科医生更喜欢双束重建而不是单束重建。77 名（55.8%）外科医生建议至少等待 6 个月才能重返运动，而 17 名（12.3%）至少等待 9 个月。没有外科医生建议等待 12 个月或更长时间才能重返运动。88 名（64%）外科医生不建议他们的首发跑卫在重返运动时在运动中使用支架。
BPTB 是 NFL 和 NCAA 一级团队医生在其精英级跑卫中进行 ACL 重建时最常使用的移植物。几乎所有外科医生都始终使用单束技术，并且大多数不建议跑卫在重返运动时使用支架。大多数患者在术后至少 6 个月重返运动，一些外科医生需要正常检查和正常重返运动测试（单腿跳跃）。
