A decision-making scheme for returning patients to high-level activity with nonoperative treatment after anterior cruciate ligament rupture
A decision-making scheme for returning patients to high-level activity with nonoperative treatment after anterior cruciate ligament rupture
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DOI：
10.1007/s001670050190
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发表时间：
2000-03-01
影响因子：
3.8
通讯作者：
Snyder-Mackler, L
中科院分区：
文献类型：
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作者：
Fitzgerald, GK;Axe, MJ;Snyder-Mackler, L
本报告描述了前交叉韧带断裂患者恢复高水平体力活动的非手术治疗决策标准的制定和当前使用情况，并介绍了符合非手术康复标准并试图恢复高水平体力活动的患者的治疗结果。筛选检查包括四个单腿跳跃试验，膝关节屈服的发生率，自我报告的功能调查，和自我报告的全球膝关节功能评级。我们筛选了93例急性单侧前交叉韧带断裂的连续患者，将其分为非手术治疗的候选者（n = 39，42%）或非候选者（n = 54，58%）。在39名康复候选人中，28人选择了非手术治疗并恢复到损伤前的活动水平，其中22人（79%）恢复到损伤前的活动水平，没有进一步的不稳定或功能状态降低。没有患者因康复或恢复活动而遭受额外的关节或踝关节损伤。本研究中描述的决策方案显示了确定谁可以安全地推迟手术重建和暂时恢复体力活动的希望。建议继续进行研究，以完善和进一步验证决策方案。
This report describes the development and current use of decision-making criteria for returning patients to high-level physical activity with nonoperative management of anterior cruciate ligament ruptures, and presents the results of treatment for patients who met our criteria as candidates for nonoperative rehabilitation and attempted to return to high-level physical activity with nonoperative management. The screening examination consists of four one-legged hop tests, the incidence of knee giving-way, a self-report functional survey, and a self-report global knee function rating. We screened 93 consecutive patients with acute unilateral anterior cruciate ligament rupture, classifying them as either candidates (n = 39, 42%) or noncandidates (n = 54, 58%) for nonoperative management. Of the 39 rehabilitation candidates 28 chose nonoperative management and returned to preinjury activity levels, 22 of whom (79%) returned to preinjury activity levels without Further episodes of instability or a reduction in functional status. No patient sustained additional articular or meniscal damage as a result of rehabilitation or return to activity. The decision-making scheme described in this study shows promise in determining who can safely postpone surgical reconstruction and temporarily return to physically demanding activities. Continued study to refine and further validate the decision-making scheme is recommended.