Return to Sport After ACL Reconstruction
Return to Sport After ACL Reconstruction
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DOI：
10.3928/01477447-20140124-10
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发表时间：
2014-02-01
期刊：
影响因子：
1.1
通讯作者：
Cole, Brian J.
中科院分区：
文献类型：
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作者：
Harris, Joshua D.;Abrams, Geoffrey D.;Cole, Brian J.
前交叉韧带（ACL）重建后允许安全恢复运动的客观指南很少使用。本研究的目的是确定已发表的I级随机对照试验中ACL重建术后恢复运动指南。使用系统性综述和荟萃分析（PRISMA）指南的首选报告项目进行系统性综述。如果I级随机对照试验报告ACL重建后至少随访2年并恢复运动标准，则纳入I级随机对照试验。分析的结果是开始恢复运动的时间，随访时间，以及使用定量/定性标准来确定恢复运动。纳入了49项研究（N= 4178; 68%为男性;平均患者年龄为27.5 ± 3.2岁;平均随访时间为3.0 ± 1.9年;从损伤到重建的平均时间为379 ± 321天）。96%的重建使用自体移植物，87%为单束重建。在67%、31%、31%和82%的研究中分别进行了Lysholm评分、单腿跳跃、等速力量和KT-1000或KT-2000关节测量仪（MEDmetric，San Diego，加州）测试。只有5项研究报告了患者是否能够成功恢复运动。90%和65%的研究分别没有使用客观标准或任何标准来允许重返体育运动。允许/津贴返回体育的描述是高度可变和穷人。24%的研究未能报告患者何时被允许无限制地重返体育活动。总体而言，分别有39%、45%和51%的研究允许在3个月时跑步，在6个月时恢复切割/旋转运动，并在6个月时恢复无限制运动。有必要对经过验证的重返运动指南进行进一步研究，以填补当代文献中的现有空白，并指导临床实践。
Objective guidelines permitting safe return to sport following anterior cruciate ligament (ACL) reconstruction are infrequently used. The purpose of this study was to determine the published return to sport guidelines following ACL reconstruction in Level I randomized controlled trials. A systematic review was performed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Level I randomized controlled trials were included if they reported a minimum 2-year follow-up after ACL reconstruction and return to sport criteria. Outcomes analyzed were the timing of initiation of return to sport, follow-up duration, and use of quantitative/qualitative criteria to determine return to sport. Forty-nine studies were included (N= 4178; 68% male; mean patient age, 27.5 +/- 3.2 years; mean follow-up, 3.0 +/- 1.9 years; mean time from injury to reconstruction, 379 +/- 321 days). Ninety-six percent of reconstructions used autograft and 87% were single-bundle reconstructions. Lysholm score, single-leg hop, isokinetic strength, and KT-1000 or KT-2000 arthrometer (MEDmetric, San Diego, California) testing were performed in 67%, 31%, 31%, and 82% of studies, respectively. Only 5 studies reported whether patients were able to successfully return to sport. Ninety percent and 65% of studies failed to use objective criteria or any criteria, respectively, to permit return to sport. Description of permission/allowance to return to sport was highly variable and poor. Twenty-four percent of studies failed to report when patients were allowed return to sport without restrictions. Overall, 39%, 45%, and 51% of studies permitted running at 3 months, return to cutting/pivoting sports at 6 months, and return to sport without restrictions at 6 months, respectively. Further research into validated return to sport guidelines is necessary to fill the existing void in contemporary literature and to guide clinical practice.