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多韧带重建膝关节术后康复:系统评价。

Postoperative Rehabilitation of Multiligament Knee Reconstruction: A Systematic Review.

机构信息

Department of Orthopaedics, Medstar Georgetown University Hospital.

Georgetown University School of Medicine.

出版信息

Sports Med Arthrosc Rev. 2021 Jun 1;29(2):94-109. doi: 10.1097/JSA.0000000000000308.

Abstract

BACKGROUND

Multiligamentous knee injuries (MLKIs) are rare, and heterogeneous in presentation and treatment options. Consequently, optimal postoperative rehabilitation of MLKI remains unclear.

OBJECTIVE

To summarize the latest evidence for postoperative rehabilitation protocols following multiligamentous knee reconstruction (MLKR).

PATIENTS AND METHODS

A multidatabase search was conducted with the aid of a health sciences librarian. Blinded reviewers conducted multiple screenings of studies evaluating postoperative rehabilitation protocols following MLKR. All included studies were then graded based on level of evidence, and data concerning patient demographics and rehabilitation protocols were extracted.

RESULTS

MLKR rehabilitation protocols differ widely in terms of weightbearing, bracing, initiation, and types of physical therapy, yet several established protocols were referenced frequently throughout the literature. Such protocols resulted in good outcomes, with patients returning to running in 6 to 12 months and returning to sport in 8 to 12 months.

CONCLUSION

The rare nature of MLKI hinders the ability to create a standardized rehabilitation protocol. However, early postoperative physical therapy and range of motion consistently lead to improved outcomes. Randomized studies are needed to determine optimal postoperative rehabilitation following MLKR.

摘要

背景

多韧带膝关节损伤(MLKIs)较为罕见,在表现和治疗选择方面存在异质性。因此,MLKI 的最佳术后康复仍不清楚。

目的

总结多韧带膝关节重建(MLKR)后术后康复方案的最新证据。

患者和方法

在健康科学图书馆员的帮助下进行了多数据库检索。经过多位评审员对评估 MLKR 后术后康复方案的研究进行了多次筛选。然后,根据证据水平对所有纳入的研究进行了分级,并提取了有关患者人口统计学和康复方案的数据。

结果

MLKR 康复方案在负重、支具、开始和物理治疗类型方面差异很大,但文献中经常提到几种既定的方案。这些方案的结果良好,患者在 6 至 12 个月内恢复跑步,在 8 至 12 个月内恢复运动。

结论

MLKI 的罕见性质阻碍了制定标准化康复方案的能力。然而,早期术后物理治疗和活动范围始终可以改善结果。需要进行随机研究来确定 MLKR 后的最佳术后康复。

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