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是时候反思前交叉韧带重建术后恢复运动的时机了。

Time to Reflect on Return to Sport Timing Following ACL Reconstruction.

作者信息

Bodkin Stephan G

机构信息

Department of Physical Therapy and Athletic Training, University of Utah, 290 S 1850 E, HPER-W 113, Salt Lake City, UT, 84115, USA.

出版信息

Sports Med. 2024 Jul;54(7):1749-1754. doi: 10.1007/s40279-024-02017-0. Epub 2024 Mar 30.

DOI:10.1007/s40279-024-02017-0
PMID:38554249
Abstract

The time of return to sport following anterior cruciate ligament (ACL) reconstruction is a commonly discussed topic within clinical settings and the sports medicine literature. Emerging science has demonstrated protective effects of delaying the time of sport clearance on athlete reinjury. Though a single time cutoff is unlikely to be applicable for all athletes, large inconsistencies in the time of return to sport clearance are present in both the literature and within prescribed clinical protocols. A multitude of patient factors, such as perceived function, objective function, confidence, post-operative goals, among others, are vital for how athletes are progressed and released for sport participation. This Current Opinion article is constructed to discuss the time to return to sport after ACL reconstruction-factors that may influence timing decisions, how time is assessed within the scientific literature-and to promote discussion on this common topic within the sports medicine and athletic communities. The aim of the article is not to establish defined clinical time cutoffs for this population.

摘要

前交叉韧带(ACL)重建术后恢复运动的时间是临床环境和运动医学文献中经常讨论的话题。新兴科学已经证明,推迟运动许可时间对运动员再次受伤具有保护作用。尽管单一的时间节点不太可能适用于所有运动员,但在文献和规定的临床方案中,恢复运动许可的时间存在很大差异。许多患者因素,如感知功能、客观功能、信心、术后目标等,对于运动员如何逐步恢复并获得运动参与许可至关重要。这篇“当前观点”文章旨在讨论ACL重建术后恢复运动的时间——可能影响时间决策的因素、科学文献中如何评估时间——并促进运动医学和体育界对这一常见话题的讨论。本文的目的不是为该人群确定明确的临床时间节点。

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本文引用的文献

1
Evaluation of Graft Ligamentization by MRI After Anterior Cruciate Ligament Reconstruction.前交叉韧带重建后 MRI 评估移植物韧带化。
Am J Sports Med. 2023 May;51(6):1466-1479. doi: 10.1177/03635465231160790. Epub 2023 Apr 4.
2
Utilization of Mid-Thigh Magnetic Resonance Imaging to Predict Lean Body Mass and Knee Extensor Strength in Obese Adults.利用大腿中部磁共振成像预测肥胖成年人的瘦体重和膝关节伸肌力量
Front Rehabil Sci. 2022;3. doi: 10.3389/fresc.2022.808538. Epub 2022 Mar 24.
3
Patient function in serial assessments throughout the post-ACL reconstruction progression.
患者在 ACL 重建后进展的连续评估中的功能。
Phys Ther Sport. 2021 Jan;47:85-90. doi: 10.1016/j.ptsp.2020.11.025. Epub 2020 Nov 11.
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The Influence, Barriers to and Facilitators of Anterior Cruciate Ligament Rehabilitation Adherence and Participation: a Scoping Review.前交叉韧带康复依从性与参与度的影响因素、障碍及促进因素:一项范围综述
Sports Med Open. 2020 Jul 17;6(1):32. doi: 10.1186/s40798-020-00258-7.
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Factors Influencing Return to Play and Second Anterior Cruciate Ligament Injury Rates in Level 1 Athletes After Primary Anterior Cruciate Ligament Reconstruction: 2-Year Follow-up on 1432 Reconstructions at a Single Center.单中心 1432 例初次前交叉韧带重建后 1 级运动员重返赛场和再次前交叉韧带损伤率的影响因素:2 年随访结果
Am J Sports Med. 2020 Mar;48(4):812-824. doi: 10.1177/0363546519900170. Epub 2020 Feb 7.
6
Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return.前交叉韧带重建后 9 个月内重返运动的年轻运动员再次受伤的几率是延迟返回的运动员的 7 倍。
J Orthop Sports Phys Ther. 2020 Feb;50(2):83-90. doi: 10.2519/jospt.2020.9071.
7
Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial.外侧关节外肌腱固定术降低了腘绳肌腱自体移植物前交叉韧带重建失败的风险:来自 STABILITY 研究的随机临床试验的 2 年结果。
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Variability in rehabilitation protocols following pediatric anterior cruciate ligament (ACL) reconstruction.小儿前交叉韧带(ACL)重建术后康复方案的变异性。
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Supervised physiotherapy leads to a better return to physical activity after anterior cruciate ligament reconstruction.在进行前交叉韧带重建术后,接受监督的物理治疗能使患者更好地恢复体育活动。
J Sports Med Phys Fitness. 2019 Sep;59(9):1551-1557. doi: 10.23736/S0022-4707.18.08692-9. Epub 2018 Dec 13.