Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, U.S.A..
Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, U.S.A.
Arthroscopy. 2021 Jan;37(1):381-387. doi: 10.1016/j.arthro.2020.06.007. Epub 2020 Jun 18.
The purpose of the current study is to systematically review the current evidence in the literature to ascertain rates of return to play after ACLR with extra-articular augmentation (EA).
A literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they evaluated and reported on return to play after ACLR + EA; case studies and review articles were excluded. The outcomes measured focused on (1) return to play, (2) return to play at the same or higher level, and (3) timing of return to play. Qualitative analysis and quantitative analysis were performed using SPSS.
Overall, 19 studies met our inclusion criteria. Among patients undergoing primary ACLR, 82.8% to 100% were able to return to play, with 64% to 100% able to return at the same or higher level of play. All professional athletes were able to return to play, and 85.7% to 100% were able to return to the same level of preoperative play. The mean time to return was 5 to 11 months in those undergoing primary ACLR + EA. Among those undergoing revision ACLR, 50% to 88.4% were able to return to play, with 41.5% to 77.8% able to return at the same or higher level of play. None of the 5 studies that compared rate of return to play (at any level) between ACLR + EA and ACLR alone found a significant difference between them. However, among the 6 studies that compared rate of return to play at the same level between ACLR + EA and ACLR alone, 2 studies found a significantly higher rate of return to play with ACLR + EA.
ACLR + EA resulted in high levels of return to play in those undergoing either primary or revision ACLR. Additionally, comparative studies of patients undergoing primary ACLR with or without EA reported similarly high rates of return to play.
Level IV, systematic review of level I to IV studies.
本研究旨在系统回顾文献中的现有证据，以确定 ACLR 后附加关节外增强（EA）的患者重返赛场的比例。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行文献检索。如果研究评估并报告了 ACLR+EA 后的重返赛场情况，且排除了病例研究和综述文章，则纳入研究。测量的结果主要集中在（1）重返赛场，（2）以相同或更高水平重返赛场，以及（3）重返赛场的时间。使用 SPSS 进行定性分析和定量分析。
总体而言，19 项研究符合我们的纳入标准。在接受初次 ACLR 的患者中，82.8%至 100%能够重返赛场，64%至 100%能够以相同或更高的运动水平重返赛场。所有职业运动员都能够重返赛场，85.7%至 100%能够恢复到术前的相同运动水平。初次 ACLR+EA 后，平均重返赛场时间为 5 至 11 个月。在接受二次 ACLR 的患者中，50%至 88.4%能够重返赛场，41.5%至 77.8%能够以相同或更高的运动水平重返赛场。没有一项比较 ACLR+EA 和 ACLR 单独治疗后重返赛场（任何水平）的比例的 5 项研究发现两者之间存在显著差异。然而，在 6 项比较 ACLR+EA 和 ACLR 单独治疗后以相同水平重返赛场的比例的研究中，有 2 项研究发现 ACLR+EA 的重返赛场比例明显更高。
ACLR+EA 使接受初次或二次 ACLR 的患者重返赛场的比例较高。此外，对接受初次 ACLR 并接受或不接受 EA 治疗的患者进行的比较研究报告的重返赛场比例也很高。
IV 级，对 I 至 IV 级研究的系统评价。
