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关节镜下半月板切除术后的康复

Rehabilitation following arthroscopic meniscectomy.

作者信息

St-Pierre D M

机构信息

School of Physical and Occupational Therapy, McGill University, Montréal, Queébec, Canada.

出版信息

Sports Med. 1995 Nov;20(5):338-47. doi: 10.2165/00007256-199520050-00005.

Abstract

Meniscal injuries are reported to be the most common injury sustained by athletes, with sports injuries being responsible for over 30% of the total number of lesions. Treatment of meniscal lesions has evolved considerably over the past 20 years and partial meniscectomies, or menisci repairs, are now the treatment of choice for the majority of lesions. Following arthroscopic meniscectomy, patients are routinely able to walk without support within 1 to 3 days, return to work after 1 to 2 weeks, resume athletic training by 2 to 4 weeks and return to competition in 3 to 4 weeks. Physiotherapy has been widely prescribed following arthroscopic meniscectomy and exercise protocols have been described in the literature. However, few studies have actually ascertained whether or not physiotherapy accelerates recovery. From these studies, there is little doubt that some form of rehabilitation, e.g. pain control or exercises, may be effective in accelerating the recovery of muscle strength to preoperative values. Therefore, whether or not physiotherapy is required following arthroscopic meniscectomy may depend on the presence or absence of preoperative strength deficits, and thus, on whether it is the dominant or nondominant leg that is injured. In patients with no preoperative deficits, and a normal post-surgery evolution, full recovery may be expected within 6 weeks if pain and swelling are brought under control. Physiotherapy intervention may not, perhaps, be justified for these patients, except in professional athletes where a faster return to preoperative values may be desired.

摘要

据报道,半月板损伤是运动员最常见的损伤,运动损伤占所有损伤总数的30%以上。在过去20年里,半月板损伤的治疗方法有了很大的发展,目前大部分损伤的治疗选择是部分半月板切除术或半月板修复术。关节镜下半月板切除术后,患者通常在1至3天内就能无需支撑行走,1至2周后恢复工作,2至4周后恢复体育训练,3至4周后重返比赛。关节镜下半月板切除术后,物理治疗已被广泛应用,文献中也描述了相关的运动方案。然而,很少有研究实际确定物理治疗是否能加速恢复。从这些研究来看,毫无疑问,某种形式的康复治疗,如疼痛控制或锻炼,可能有助于加速肌肉力量恢复到术前水平。因此,关节镜下半月板切除术后是否需要物理治疗可能取决于术前是否存在力量不足,进而取决于受伤的是优势腿还是非优势腿。对于术前没有力量不足且术后恢复正常的患者,如果疼痛和肿胀得到控制,预计6周内可完全恢复。对于这些患者,物理治疗干预可能没有必要,除非是职业运动员,他们可能希望更快恢复到术前水平。

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