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肩锁关节脱位 Rockwood III-VI 级手术后的重返运动。

Return to sport after surgical treatment for high-grade (Rockwood III-VI) acromioclavicular dislocation.

机构信息

Department of Orthopaedic Surgery, OLVG, Postbus 95500, 1090 HM, Amsterdam, The Netherlands.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2019 Dec;27(12):3803-3812. doi: 10.1007/s00167-019-05528-w. Epub 2019 May 14.

Abstract

PURPOSE

Acromioclavicular (AC) joint dislocations are common in a young and active population, especially in people performing contact sports. Full recovery with a fast and high rate of return to sport is desirable. This systematic review aims to combine patient outcomes in order to help surgeons in addressing patient expectations regarding the return to sport after surgical intervention for AC dislocations.

METHODS

To conduct this systematic review, the PRISMA guidelines were followed. Articles were included if written in English or Dutch and evaluated return to sport after any type of surgical intervention for Rockwood types III to VI AC dislocations in patients practicing sports. Outcome parameters were return to sport, time to return to sport, level of sport, functional outcome scores and complications.

RESULTS

Twelve studies involving 498 patients were included, of which 462 patients practiced sports. 432 (94%) patients returned to sport. The weighted mean time to return to sport was 4.0 months. 338 out of 401 patients (84%) returned to the same level of pre-injury sport and 35 patients (9%) lowered their level of sport. The weighted mean Constant score was 92 out of 100.

CONCLUSION

The rate of return to sport after surgical intervention for Rockwood (RW) III-VI AC dislocations is high. However, the level of evidence was low and due to the methodological heterogeneity between studies, subgroup analyses of return to sport outcomes were not feasible.

LEVEL OF EVIDENCE

Systematic review of level I-IV studies, level IV.

摘要

目的

肩锁关节(AC)脱位在年轻且活跃的人群中很常见,尤其是从事接触性运动的人群。理想情况下,患者应能快速完全康复并尽快重返运动。本系统评价旨在综合患者的结局,以帮助外科医生满足患者对 AC 脱位手术后重返运动的期望。

方法

为进行本系统评价,我们遵循了 PRISMA 指南。如果文章以英文或荷兰文发表,并评估了任何类型的手术干预治疗 Rockwood III 至 VI 型 AC 脱位患者的运动后重返运动情况,则将其纳入。结局参数包括重返运动、重返运动的时间、运动水平、功能结局评分和并发症。

结果

共纳入了 12 项研究,涉及 498 例患者,其中 462 例患者从事运动。432 例(94%)患者重返运动。重返运动的加权平均时间为 4.0 个月。401 例患者中有 338 例(84%)重返受伤前的运动水平,35 例患者(9%)降低了运动水平。加权平均 Constant 评分为 92 分(满分 100 分)。

结论

对于 Rockwood(RW)III-VI 型 AC 脱位,手术后重返运动的比例较高。然而,证据水平较低,且由于研究之间存在方法学异质性,无法对重返运动结局进行亚组分析。

证据等级

I-IV 级研究的系统评价,IV 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3882/6874623/6391cdcb6696/167_2019_5528_Fig1_HTML.jpg

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