Valle Christina, Hirschmüller Anja, Schmitt-Sody Marcus, Haller Bernhard, Keller Matthias, Schoch Wolfgang, Hoffman Helmut, Minzlaff Philipp
Medical Park Chiemsee, Bernau-Felden.
Universitätsklinikum Freiburg, Freiburg.
Sportverletz Sportschaden. 2018 Jun;32(2):103-110. doi: 10.1055/a-0583-3850. Epub 2018 Jun 5.
Rehabilitation protocols following anterior cruciate ligament (ACL) reconstruction often differ among orthopaedic surgeons. The primary aim of this study was to investigate which follow-up treatment is recommended by "AGA instructors" certified by the German-speaking Association for Arthroscopic and Open Joint Surgery (AGA). The secondary aim was to compare these findings with the current literature.
A structured anonymous online survey was performed with "AGA instructors" specialised in knee or ACL surgery. All participants were asked about their recommendations for rehabilitation following isolated ACL reconstruction using a questionnaire containing 23 items.
117 out of 218 mail questionnaires were fully completed and analysed. 96.5 % of all surgeons allowed full weight-bearing after 4 weeks or earlier, 52.6 % put a limit on knee flexion, 9.7 % on knee extension after the operation. A brace was prescribed by 82.8 % of all participants. During the first six weeks, isometric training and closed-chain exercises were recommended by the majority of surgeons. Riding a bicycle or driving a car after 6 weeks or earlier was permitted by 78.5 % and 86.2 %, respectively. Jogging (65.5 %) or jumping activities (67.0 %) were allowed after 3 months or earlier. Skiing (53.0 %) or contact/team sport (55.2 % / 46.2 %) was often permitted after 12 months. 82.6 % of all surgeons would like to use return-to-sport test protocols.
Rehabilitation protocols differ significantly even among experienced knee surgeons working as instructors. Their recommendations are often not evidence-based considering the current literature.
前交叉韧带（ACL）重建后的康复方案在骨科医生中往往存在差异。本研究的主要目的是调查德语区关节镜与开放关节手术协会（AGA）认证的“AGA教员”推荐哪种后续治疗方法。次要目的是将这些结果与当前文献进行比较。
对专门从事膝关节或ACL手术的“AGA教员”进行了一项结构化匿名在线调查。所有参与者都被要求使用一份包含23个项目的问卷，回答他们对孤立ACL重建后康复的建议。
218份邮寄问卷中有117份被完全填写并分析。96.5%的外科医生允许在4周或更早时间后完全负重，52.6%的医生对术后膝关节屈曲设限，9.7%的医生对膝关节伸展设限。82.8%的参与者开了支具处方。在最初六周内，大多数外科医生推荐等长训练和闭链运动。78.5%和86.2%的医生分别允许在6周或更早时间后骑自行车或开车。65.5%的医生允许在3个月或更早时间后慢跑，67.0%的医生允许进行跳跃活动。53.0%的医生允许在12个月后滑雪，55.2%/46.2%的医生允许在12个月后进行接触性/团队运动。82.6%的外科医生希望使用重返运动测试方案。
即使在担任教员的经验丰富的膝关节外科医生中，康复方案也存在显著差异。考虑到当前文献，他们的建议往往缺乏循证依据。
