Lynch Andrew D, Chmielewski Terese, Bailey Lane, Stuart Michael, Cooper Jonathan, Coady Cathy, Sgroi Terrance, Owens Johnny, Schenck Robert, Whelan Daniel, Musahl Volker, Irrgang James
University of Pittsburgh, 100 Technology Drive, Pittsburgh, PA, 15219, USA.
TRIA Orthopaedic Center, Minneapolis, MN, USA.
Curr Rev Musculoskelet Med. 2017 Sep;10(3):328-345. doi: 10.1007/s12178-017-9425-4.
The purpose of this manuscript is twofold: (1) to review the literature related to rehabilitation after surgery for multiple ligament knee injury (MLKI) and after isolated surgery for the posterior cruciate ligament (PCL), posterolateral corner (PLC), and medial side of the knee and (2) to present a hierarchy of anatomic structures needing the most protection to guide rehabilitation.
MLKIs continue to be a rare but devastating injury. Recent evidence indicates that clinicians may be providing too much protection from early weight bearing and range of motion, but an accelerated approach has not been rigorously tested. Consideration of the nature and quality of surgical procedures (repair and reconstruction) can help clinicians determine the structures needing the most protection during the rehabilitation period. The biomechanical literature and prior clinical experience can aid clinicians to better structure rehabilitation after surgery for MLKI and improve clinical outcome for patients.
本手稿的目的有两个：（1）回顾与多韧带膝关节损伤（MLKI）手术后以及单纯后交叉韧带（PCL）、膝关节后外侧角（PLC）和膝关节内侧手术后康复相关的文献；（2）提出需要给予最大程度保护以指导康复的解剖结构层次。
MLKIs仍然是一种罕见但具有毁灭性的损伤。最近的证据表明，临床医生可能在早期负重和活动范围方面给予了过多保护，但加速康复方法尚未经过严格测试。考虑手术操作（修复和重建）的性质和质量有助于临床医生确定康复期间最需要保护的结构。生物力学文献和既往临床经验可以帮助临床医生更好地构建MLKI手术后的康复方案，并改善患者的临床结局。
