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运动员前盂肱关节不稳治疗的拉塔热手术——康复的关键考虑因素

Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability in the Athlete - Key Considerations for Rehabilitation.

作者信息

Bradley Helen, Lacheta Lucca, Goldenberg Brandon T, Rosenberg Samuel I, Provencher Matthew T, Millett Peter J

机构信息

Howard Head Sports Medicine.

Steadman Philippon Research Institute; Charité-Universitätsmedizin Berlin.

出版信息

Int J Sports Phys Ther. 2021 Feb 1;16(1):259-269. doi: 10.26603/001c.18707.

Abstract

The Latarjet procedure with transfer of the coracoid process and its attached conjoint tendon is a well-established surgical technique for the treatment of anterior glenohumeral instability in patients with anteroinferior bone loss and/or high risk for recurrence. Biomechanical and clinical studies have shown excellent results and high rates of return to sports. However, there is an absence of standardized, objective criteria to accurately assess an athlete's ability to progress through each phase of rehabilitation. Return to sports rehabilitation, progressed by quantitatively measured functional goals, may improve the athlete's integration back to sports participation. Therefore, the purpose of this clinical commentary is to provide a rehabilitation protocol for the Latarjet procedure, progressing through clearly defined phases, with guidance for safe and effective return to sport. Recommended criteria are highlighted which allows the clinician to progress the patient through each phase appropriately rather than purely following timeframes from surgery. This progression ensures the patient has completed a thorough rehabilitation program that addresses ROM, strength, power, neuromuscular control and a graded return to play. Level of Evidence: 5.

摘要

喙突及其附着的联合肌腱转移的Latarjet手术是治疗存在前下骨质丢失和/或复发高风险的患者肩肱关节前向不稳的成熟外科技术。生物力学和临床研究已显示出优异的结果以及很高的恢复运动率。然而,缺乏标准化的客观标准来准确评估运动员在康复各阶段的进展能力。通过定量测量的功能目标推进的恢复运动康复,可能会提高运动员重新参与运动的融入度。因此,本临床述评的目的是提供一份Latarjet手术的康复方案,按明确界定的阶段推进,并为安全有效地恢复运动提供指导。文中突出了推荐标准,这使临床医生能够适当地推动患者度过各阶段,而不是单纯遵循手术后的时间框架。这种推进确保患者完成了一个全面的康复计划,该计划涉及关节活动度、力量、功率、神经肌肉控制以及分级恢复比赛。证据等级:5级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/693a/7872454/082e5013202e/ijspt_2021_16_1_18707_50132.jpg

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