School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, 3086, Australia.
OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.
J Orthop Traumatol. 2019 Jan 28;20(1):10. doi: 10.1186/s10195-018-0516-9.
Most athletes who undergo anterior cruciate ligament (ACL) reconstruction surgery plan to return to some level of sporting activity. However, rates of return to pre-injury sport are often less than might be expected and many factors influence whether individuals return to sport after this surgery. They include surgical and rehabilitation factors as well as social, psychological and demographic characteristics. The fate of the younger athlete who sustains an ACL injury is a topic that has received recent attention due to accumulating evidence that younger athletes are at considerable risk for not only one, but multiple ACL injuries. Little is known about how to determine when it is safe to return to sport following ACL reconstruction or how to predict whether an athlete will be able to successfully return. The notion that a set of return to sport criteria can be applied to reduce the risk of further injury has become popular with many different criteria proposed. Another risk of returning to sport following ACL reconstruction is that of sustaining injury to the menisci or articular surfaces, which may in turn increase the risk of developing osteoarthritis. Although there is some evidence that ACL reconstruction reduces the risk of osteoarthritis there is stronger evidence that it does little to protect the knee from long term degeneration. Therefore, it should be recognized that return to sport following ACL reconstruction is associated with a risk of further injury and potential development of osteoarthritis.Level of evidence: V.
大多数接受前交叉韧带（ACL）重建手术的运动员都计划恢复某种程度的运动活动。然而，术后恢复到受伤前运动水平的比例往往低于预期，许多因素会影响个体在手术后是否恢复运动。这些因素包括手术和康复因素以及社会、心理和人口统计学特征。年轻运动员遭受 ACL 损伤的命运是一个最近受到关注的话题，因为越来越多的证据表明，年轻运动员不仅面临一次 ACL 损伤的风险，而且还面临多次 ACL 损伤的风险。对于ACL 重建后何时可以安全返回运动，以及如何预测运动员是否能够成功返回，知之甚少。一套返回运动标准可以应用于降低进一步受伤的风险的概念已在许多不同的标准中得到了广泛的应用。ACL 重建后重返运动的另一个风险是半月板或关节面受伤，这反过来又可能增加患骨关节炎的风险。虽然有一些证据表明 ACL 重建可以降低骨关节炎的风险，但也有更强的证据表明，它对保护膝关节免受长期退化几乎没有作用。因此，应该认识到，ACL 重建后重返运动与进一步受伤的风险以及潜在的骨关节炎发展有关。证据水平：V。
