Weiler Richard, Monte-Colombo Mathew, Mitchell Adam, Haddad Fares
Department of Sport Medicine and Science, West Ham United Football Club Training Ground, Chadwell Heath, Essex, UK UCL Institute of Sport, Exercise & Health and University College London Hospitals NHS Foundation Trust, London, UK The FA Centre for Disability Football Research, Burton-Upon-Trent, UK.
University of Hertfordshire, Hatfield, UK.
BMJ Case Rep. 2015 Apr 26;2015:bcr2014208012. doi: 10.1136/bcr-2014-208012.
This case report illustrates and discusses the non-operative management of a complete anterior cruciate ligament (ACL) injury in an English Premier League football player, his return to play within 8 weeks and problem-free follow-up at 18 months post injury. When non-operative verses surgical ACL reconstruction is considered there are many fundamental gaps in our knowledge and currently, at elite level, there are no cases in cutting sports within the literature to guide these decisions. When the norm is for all professional footballers to be recommended surgery, it will be very challenging when circumstances and patient autonomy dictate a conservative approach, where prognosis, end points and risk are unclear and assumed to be high. This case challenges current dogma and provides a starting point for much needed debate about best practice, treatment options, research direction and not just at the elite level of sport.
本病例报告阐述并讨论了一名英超足球运动员前交叉韧带完全损伤的非手术治疗情况，他在受伤后8周内重返赛场，并在伤后18个月随访时未出现问题。在考虑非手术与手术重建前交叉韧带时，我们的认知存在许多根本性差距，目前在精英层面，文献中尚无关于竞技运动中此类情况的案例来指导这些决策。当通常建议所有职业足球运动员接受手术时，在情况和患者自主性决定采取保守治疗方法（此时预后、终点和风险不明且被认为很高）时，将极具挑战性。本病例对当前的教条提出了挑战，并为关于最佳实践、治疗选择、研究方向的急需辩论提供了一个起点，而且不仅适用于精英体育层面。
