前十字带 (ACL) 破裂的交叉支协议与手术稳定相比,失败率不可接受地高:为期2年的受控队列研究
Mark D Porter1, Bruce Shadbolt1,2
1Canberra Orthopaedics and Sports Medicine; Canberra, ACT, Australia.
概括
前交叉带 (ACL) 破裂的交叉支协议 (CBP) 导致反复不稳定性和半径撕裂的发生率明显高,与旋转运动运动运动员的手术稳定相比. 这种非手术的方法不建议活跃的个体.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学运动医学
- 生物力学 生物力学
背景情况:
- 前十字带 (ACL) 断裂是参加旋转运动的运动员常见的伤害.
- 治疗方案包括手术稳定和非手术方案,如交叉支协议 (CBP).
- 活跃个体中ACL破裂的最佳管理策略仍然是正在进行的研究的主题.
研究的目的:
- 为了比较ACL破裂患者的临床结果,使用交叉支协议 (CBP) 与手术稳定治疗.
- 为了评估两组治疗群体之间反复出现的不稳定性和阴茎撕裂的发生率.
- 在CBP和手术干预后评估患者报告的结果措施 (PROM).
主要方法:
- 进行了一项观察性前性队列研究,随访2年.
- 包括80名骨成熟的患者 (16-40岁) 与孤立的ACL破裂,打算回到旋转运动.
- 患者被分为两组:A组 (40名患者) 接受了手术稳定,B组 (40名患者) 接受了CBP.
主要成果:
- B组 (CBP) 显示出现反复不稳定的风险明显较高 (70%对2.5%,P<0.001).
- 中部半月膜撕裂的发生率在B组显著增加 (62%对2.5%,P<0.001).
- 与手术组相比,在CBP组中,所有患者报告的结果指标 (PROMs) 在CBP组显著下降 (P < 0.001).
结论:
- 交叉支协议 (CBP) 与不可接受的高率的反复不稳定性和二次损伤,如半径撕裂有关.
- 外科稳定似乎在参与旋转运动的运动员中为前十字带断裂带来了优异的临床结果.
- 不推使用CBP进行非手术治疗,对于在ACL破裂后寻求恢复高需求的旋转活动的患者.
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