Irrgang J J, Pezzullo D
University of Pittsburgh, School of Health and Rehabilitation Sciences, Department of Physical Therapy, PA 15260, USA.
J Orthop Sports Phys Ther. 1998 Oct;28(4):232-40. doi: 10.2519/jospt.1998.28.4.232.
Knowledge of the structure and function of articular cartilage is important when considering rehabilitation following surgical procedures for articular cartilage lesions of the knee. Articular cartilage is avascular and derives its nutrition primarily from synovial fluid, resulting in a limited potential for regeneration. Basic science evidence has demonstrated that compressive loading may have a positive impact on articular cartilage healing; however, excessive shear loading may be detrimental. Rehabilitation following surgical procedures for articular cartilage lesions should include controlled range of motion exercises. Exercises to enhance muscle function must be done in a manner which minimizes shear loading of the joint surfaces in the area of the lesion. A period of protected weight bearing is often necessary and should be followed by progressive loading of the joint. This article will: 1) provide a brief review of the structure and function of articular cartilage lesions as it relates to rehabilitation; 2) describe common surgical procedures to address articular cartilage lesions; and 3) provide guidelines for rehabilitation following surgical management of articular cartilage lesions.
在考虑膝关节软骨损伤手术后的康复问题时，了解关节软骨的结构和功能非常重要。关节软骨无血管，其营养主要来自滑液，这导致其再生潜力有限。基础科学证据表明，压缩负荷可能对关节软骨愈合有积极影响；然而，过度的剪切负荷可能有害。膝关节软骨损伤手术后的康复应包括控制活动范围的练习。增强肌肉功能的练习必须以尽量减少损伤区域关节面剪切负荷的方式进行。通常需要一段时间的保护性负重，随后应逐渐增加关节负荷。本文将：1）简要回顾与康复相关的关节软骨损伤的结构和功能；2）描述治疗关节软骨损伤的常见手术方法；3）提供关节软骨损伤手术治疗后康复的指导原则。
