Memmel Clemens, Koch Matthias, Szymski Dominik, Huber Lorenz, Pfeifer Christian, Knorr Christian, Alt Volker, Krutsch Werner
Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center and FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany.
Department of Trauma Surgery and FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany.
J Pers Med. 2022 Aug 8;12(8):1299. doi: 10.3390/jpm12081299.
(1) Background: Isolated posterior cruciate ligament (PCL) tears represent a severe type of injury. In hospitals, PCL reconstruction (PCL-R) is less frequently performed than other types of knee surgery. It is unclear whether there is consensus among surgeons on how to perform rehabilitation after PCL-R or if there are different, more individual approaches in daily routines. (2) Methods: Rehabilitation protocols and their main criteria (the progression of weight bearing and range of motion, the use of knee braces, rehabilitation training, and sports-specific training) were retrospectively analyzed after PCL-R. (3) Results: Only 33 of 120 (27.5%) analyzed institutes use rehabilitation protocols after PCL-R. The applied protocols showed vast differences between the individual rehabilitation criteria, especially with regard to the progression of weight bearing and the range of motion. The only standardized recommendations were the obligatory use of knee braces and the general restriction of weight bearing and range of motion immediately post-surgery. Therefore, because of the lack of a consensus about a standardized rehabilitation protocol after PCL-R, no recommendation can be made on one particular protocol. (4) Conclusion: There is no acknowledged standardized rehabilitation protocol after PCL-R. In clinical practice, recommendations are influenced by, i.a., surgeons' opinions and experience. The lack of scientific evidence on a particular standardized rehabilitation protocol after PCL-R suggests that rehabilitation protocols need to be tailored to the individual patient.
(1) 背景：单纯后交叉韧带（PCL）撕裂是一种严重的损伤类型。在医院中，PCL重建术（PCL-R）的开展频率低于其他类型的膝关节手术。目前尚不清楚外科医生在PCL-R术后如何进行康复治疗方面是否存在共识，或者在日常实践中是否存在不同的、更具个性化的方法。(2) 方法：对PCL-R术后的康复方案及其主要标准（负重进展和活动范围、膝关节支具的使用、康复训练以及专项运动训练）进行回顾性分析。(3) 结果：在120家被分析的机构中，只有33家（27.5%）在PCL-R术后使用康复方案。所应用的方案在各个康复标准之间存在巨大差异，尤其是在负重进展和活动范围方面。唯一标准化的建议是术后必须使用膝关节支具以及对负重和活动范围进行一般限制。因此，由于PCL-R术后缺乏关于标准化康复方案的共识，无法对某一特定方案给出推荐。(4) 结论：PCL-R术后不存在公认的标准化康复方案。在临床实践中，建议受到多种因素影响，尤其是外科医生的意见和经验。PCL-R术后缺乏关于特定标准化康复方案的科学证据表明，康复方案需要根据个体患者进行定制。
