School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.
Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Sports Med. 2024 Dec;54(12):3111-3126. doi: 10.1007/s40279-024-02105-1. Epub 2024 Sep 13.
Flow limitations in the iliac arteries (FLIA) is a sport-related vascular condition increasingly recognised as an occupational risk for professional cyclists and other endurance athletes. Surgical reconstruction is the definitive treatment for athletes wishing to continue competition. However, less information has been published regarding conservative management options and return-to-sport (RTS) guidelines.
Our aim was to review the existing literature on conservative treatment of FLIA, identify knowledge gaps and propose an RTS framework for athletes returning to competition.
A comprehensive literature review was performed using the Ovid-MEDLINE, PubMed, Embase and PEDro databases for publications relevant to conservative management of FLIA. A scoping review was conducted following PRISMA-ScR guidelines. Original, peer-reviewed publications in English describing conservative or postoperative management for athletes with FLIA were included. Additional grey literature and clinical expertise were consulted to inform RTS guidelines.
Overall, 62 studies were included in this review. In total, 11 categories of conservative modalities were extracted and presented qualitatively in terms of the information source (discussion or results statements) and perspective of the authors (positive, negative or mixed). We have proposed RTS guidelines covering pre-operative preparation and postoperative rehabilitation based on the available literature, clinical experience, and drawing from other areas of sports medicine research.
There is insufficient literature evaluating the effectiveness of conservative management options for FLIA to establish best practices. Considering the importance of RTS for competitive athletes, we proposed practical guidelines to help with clinician and patient decision making. Future consensus should be sought for RTS best practices.
髂动脉血流受限（FLIA）是一种与运动相关的血管疾病，越来越多的人认为它是职业自行车手和其他耐力运动员的职业风险。对于希望继续参赛的运动员来说，手术重建是明确的治疗方法。然而，关于保守治疗选择和重返运动（RTS）指南的信息较少。
我们旨在回顾关于 FLIA 保守治疗的现有文献，确定知识空白，并为重返比赛的运动员提出 RTS 框架。
使用 Ovid-MEDLINE、PubMed、Embase 和 PEDro 数据库对与 FLIA 保守治疗相关的出版物进行全面的文献综述。根据 PRISMA-ScR 指南进行了范围综述。纳入了描述 FLIA 运动员保守或术后管理的原创、同行评议的英文出版物。还咨询了额外的灰色文献和临床专业知识，以提供 RTS 指南的信息。
共有 62 项研究纳入本综述。总共提取了 11 类保守治疗方法，并根据信息来源（讨论或结果陈述）和作者观点（积极、消极或混合）进行定性描述。我们根据现有文献、临床经验，并借鉴其他运动医学研究领域，提出了涵盖术前准备和术后康复的 RTS 指南。
评估 FLIA 保守治疗选择的有效性的文献不足，无法确定最佳实践。考虑到 RTS 对竞技运动员的重要性，我们提出了实用的指南，以帮助临床医生和患者做出决策。应寻求共识以确定 RTS 的最佳实践。
