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活动需求和不稳定性是推荐使用重建治疗 ACL 损伤的最重要因素。

Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction.

机构信息

Department of Activity and Health, Linköping University, 58183, Linköping, Sweden.

Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, 581 83, Linköping, Sweden.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2018 Aug;26(8):2401-2409. doi: 10.1007/s00167-018-4846-1. Epub 2018 Feb 6.

Abstract

PURPOSE

The purpose of the study was to (1) study and compare the factors that Swedish orthopaedic surgeons and physical therapists consider important for recommending ACL reconstruction and, (2) to assess how orthopaedic surgeons and physical therapists consider their own and each others, as well as patients', roles are in the treatment decision.

METHODS

A web-based survey assessing the relevance of 21 predetermined factors, in the choice to recommend ACL reconstruction, was sent to orthopaedic surgeons and physical therapists. Respondents were also asked to rate the importance of the assessment made by themselves, the other clinician (physical therapists rated the importance of surgeons, surgeons rated the importance of physical therapists), and the patients' preferences.

RESULT

Orthopaedic surgeons agreed of eight, and physical therapists of seven factors as important in the choice to recommend ACL reconstruction. The factors both groups reported as important were; "patient's wishes to return to contact/pivoting sports", "instability in physical activity", "instability in activities of daily living despite adequate rehabilitation", "physically demanding occupation", and "young age". Both professions rated their own and each others assessments as well as patient's wishes as important for the decision to recommend ACL reconstruction.

CONCLUSION

Orthopaedic surgeons and physical therapists agree about factors that are important for their decision to recommend ACL reconstruction, showing that both professions share a common ground in perceptions of factors that are important in recommending ACL reconstruction.

LEVEL OF EVIDENCE

Diagnostic study: Level III.

摘要

目的

本研究旨在:(1) 研究和比较瑞典骨科医生和物理治疗师认为对推荐 ACL 重建重要的因素,以及 (2) 评估骨科医生和物理治疗师如何看待自己、对方以及患者在治疗决策中的角色。

方法

一项基于网络的调查评估了 21 个预先确定的因素在推荐 ACL 重建选择中的相关性,调查对象为骨科医生和物理治疗师。调查对象还被要求评估他们自己、其他临床医生(物理治疗师评估外科医生的重要性,外科医生评估物理治疗师的重要性)以及患者偏好的评估的重要性。

结果

骨科医生同意 8 个因素,物理治疗师同意 7 个因素是推荐 ACL 重建的重要因素。两组都报告的重要因素有:“患者希望重返接触/旋转运动”、“体育活动时不稳定”、“尽管康复充分,但日常生活活动不稳定”、“体力要求高的职业”和“年轻”。两个专业都认为自己和对方的评估以及患者的意愿对推荐 ACL 重建的决策很重要。

结论

骨科医生和物理治疗师在对推荐 ACL 重建的决策重要因素上达成一致,这表明这两个专业在推荐 ACL 重建时对重要因素的看法有共同之处。

证据水平

诊断研究:III 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9d2/6061764/80c23a843707/167_2018_4846_Fig1_HTML.jpg

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