Nyland J, Caborn D N, Johnson D L, Moore J, Slone K
Section of Sports Medicine, University of Kentucky, Lexington, USA.
J South Orthop Assoc. 1998 Spring;7(1):13-8.
We wanted to determine the bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction practices of accredited orthopaedic sports medicine fellowship programs and their opinions about whether differences should exist in rehabilitation protocol, bracing, and timing of release to cutting/agility sports between autogeneic and allogeneic grafts. Our survey showed most programs did 51 to 100 BPTB ACL reconstructions during the 12 months before survey completion. Standard rehabilitation protocols were used without differences based on BPTB graft type or fixation concerns. Programs were equally divided regarding whether BPTB graft type should be a timing of release to cutting/agility sports factor. Programs were almost equally divided regarding routinely prescribed derotation braces. More programs used autograft rather than allograft BPTB tissue for ACL reconstruction, without rehabilitation protocol differences based on graft type or fixation concerns. Conflicting results regarding protocol and timing of release to cutting/agility sports indicate that several factors may contribute to the clinical decision-making process. Equivocal results regarding derotation brace prescription raises concerns regarding their necessity.
我们想要确定经认可的骨科运动医学 fellowship 项目中骨-髌腱-骨（BPTB）前交叉韧带（ACL）重建的实践情况，以及他们对于自体移植物和同种异体移植物在康复方案、支具使用以及恢复进行切割/敏捷性运动的时间方面是否应该存在差异的看法。我们的调查显示，大多数项目在调查完成前的 12 个月内进行了 51 至 100 例 BPTB ACL 重建手术。使用了标准的康复方案，且不因 BPTB 移植物类型或固定问题而有所不同。对于 BPTB 移植物类型是否应作为恢复进行切割/敏捷性运动时间的一个因素，各项目的意见平分秋色。对于常规开具旋转控制支具，各项目的意见也几乎平分秋色。更多项目在 ACL 重建中使用自体 BPTB 组织而非同种异体 BPTB 组织，且不因移植物类型或固定问题而在康复方案上存在差异。关于恢复进行切割/敏捷性运动的方案和时间的结果相互矛盾，表明可能有多个因素影响临床决策过程。关于旋转控制支具处方的结果模棱两可，引发了对其必要性的担忧。
