切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (04) : 538 -544. doi: 10.3877/cma.j.issn.1674-134X.2024.04.014

综述

膝关节前交叉韧带重建术前康复治疗的研究进展
杨滢甄1, 黄子荣2, 梁家敏1, 黄晓芳1, 胡艳2, 朱伟民1,()   
  1. 1. 518035 深圳市第二人民医院(深圳大学附属第一医院);518061 深圳大学医学部
    2. 518035 深圳市第二人民医院(深圳大学附属第一医院)
  • 收稿日期:2024-03-17 出版日期:2024-08-01
  • 通信作者: 朱伟民
  • 基金资助:
    广东省基础与应用基础研究基金(2023A1515010371); 深圳市科技计划资助(JCYJ20210324102607021); 深圳市科技计划资助(GJHZ20220913143201002); 深圳市第二人民医院2023年院级临床研究项目(2023yjlcyj030); 深圳大学医工交叉研究基金(2023YG007); 深圳市第二人民医院2024年院级临床研究项目(20243357002)

Advances in preoperative rehabilitation after anterior cruciate ligament reconstruction of knee

Yingzhen Yang1, Zirong Huang2, Jiamin Liang1, Xiaofang Huang1, Yan Hu2, Weimin Zhu1,()   

  1. 1. Department of Sports Medicine, Shenzhen Second People’s Hospital/ the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China;Shenzhen University Health Science Center, Shenzhen 518061, China
    2. Department of Sports Medicine, Shenzhen Second People’s Hospital/ the First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518035, China
  • Received:2024-03-17 Published:2024-08-01
  • Corresponding author: Weimin Zhu
引用本文:

杨滢甄, 黄子荣, 梁家敏, 黄晓芳, 胡艳, 朱伟民. 膝关节前交叉韧带重建术前康复治疗的研究进展[J]. 中华关节外科杂志(电子版), 2024, 18(04): 538-544.

Yingzhen Yang, Zirong Huang, Jiamin Liang, Xiaofang Huang, Yan Hu, Weimin Zhu. Advances in preoperative rehabilitation after anterior cruciate ligament reconstruction of knee[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(04): 538-544.

前交叉韧带损伤在年轻活跃的患者中很常见。当ACL完全断裂时,需要进行关节镜下前交叉韧带重建(ACLR)。尽管ACLR术式已经很成熟,通过手术能够修复结构缺陷,但患者术后面临膝关节肌肉力量、功能和耐力损伤,导致部分患者未能回到受伤前的运动水平。事实上,除了手术本身,康复对患者的预后也具有重要影响。研究表明,通过术前康复,可以降低手术风险,提高手术效果,帮助患者尽快恢复到不受限制的体育活动。然而目前研究者主要关注术后康复。与常规术后康复相比,对接受术前康复的患者的研究较少。本文通过归纳总结前交叉韧带重建术前康复治疗的相关临床研究成果,旨在为该病的康复诊疗方案提供新的思路与指导。

Anterior cruciate ligament injury is common in young and active patients. When the ACL is completely ruptured, arthroscopic anterior cruciate ligament reconstruction (ACLR) is needed. Although the ACLR procedure is mature and can repair structural defects, patients face knee muscle strength, function and endurance injury after surgery, resulting in some patients unable to return to the exercise level before the injury. In fact, in addition to the operation itself, rehabilitation also has an important impact on the prognosis of patients. Studies have shown that preoperative rehabilitation can reduce the risk of operation, improve the effect of operation, and help patients return to unrestricted physical activity as soon as possible. However, at present, researchers mainly focus on postoperative rehabilitation. Compared with routine postoperative rehabilitation, there are fewer studies on patients undergoing preoperative rehabilitation. This paper summarized the relevant clinical research results of rehabilitation treatment before anterior cruciate ligament reconstruction, in order to provide new ideas and guidance for the rehabilitation diagnosis and treatment of the disease.

[1]
Kim DKHwang JHPark WH. Effects of 4 weeks preoperative exercise on knee extensor strength after anterior cruciate ligament reconstruction[J]. J Phys Ther Sci2015,27(9):2693-2696.
[2]
Busfield BTKharrazi FDStarkey C,et al. Performance outcomes of anterior cruciate ligament reconstruction in the National Basketball Association[J]. Arthroscopy2009,25(8):825-830.
[3]
Ardern CLWebster KETaylor NF,et al. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play[J]. Br J Sports Med2011,45(7):596-606.
[4]
Wiggins AJGrandhi RKSchneider DK,et al. Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: asystematic review and meta-analysis[J]. Am J Sports Med2016,44(7):1861-1876.
[5]
Tayfur BCharuphongsa CMorrissey D,et al. Neuromuscular function of the knee joint following knee injuries: does it ever get back to normal?A systematic review with meta-analyses[J]. Sports Med2021,51(2):321-338.
[6]
Toohey LADrew MKCook JL,et al. Is subsequent lower limb injury associated with previous injury?A systematic review and meta-analysis[J]. Br J Sports Med2017,51(23):1670-1678.
[7]
赵宇,赵松,赵金忠. 前交叉韧带损伤及重建后继发性膝骨关节炎的研究进展[J/CD]. 中华关节外科杂志(电子版)2023,17(3):415-423.
[8]
Wilk KEArrigo CA. Rehabilitation principles of the anterior cruciate ligament reconstructed knee: twelve steps for successful progression and return to play[J]. Clin Sports Med2017,36(1):189-232.
[9]
Carter HLittlewood CWebster K,et al. The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament(ACL)reconstruction: a systematic review[J/OL]. Physiotherapy2021,113:e102-e103. DOI: 10.1016/j.physio.2021.10.080.
[10]
Giesche FNiederer DBanzer W,et al. Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: a systematic review[J/OL]. PLoS One2020,15(10):e0240192. DOI: 10.1371/journal.pone.0240192.
[11]
Ardern CLTaylor NFFeller JA,et al. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery[J]. Am J Sports Med2013,41(7):1549-1558.
[12]
Brown CMarinko LLaValley MP,et al. Quadriceps strength after anterior cruciate ligament reconstruction compared with uninjured matched controls: asystematic review and meta-analysis[J/OL]. Orthop J Sports Med2021,9(4):2325967121991534. DOI: 10.1177/2325967121991534.
[13]
Mariani PPLaudani LRocchi JE,et al. No relationship between preoperative and early postoperative strength after ACL reconstruction[J]. J Sport Rehabil2020,29(5):583-587.
[14]
Quelard BSonnery-Cottet BZayni R,et al. Preoperative factors correlating with prolonged range of motion deficit after anterior cruciate ligament reconstruction[J]. Am J Sports Med2010,38(10):2034-2039.
[15]
Garcia-Mansilla ITrivellas MSingla A,et al. Quality and variability of physical therapy protocols varies widely for osteochondral allograft transplantation of the femoral condyles[J/OL]. Cartilage2022,13(1):19476035221073999. DOI: 10.1177/19476035221073999.
[16]
Failla MJLogerstedt DSGrindem H,et al. Does extended preoperative rehabilitation influence outcomes 2 years after ACL reconstruction?A comparative effectiveness study between the MOON and delaware-oslo ACL cohorts[J]. Am J Sports Med2016,44(10):2608-2614.
[17]
Eitzen IMoksnes HSnyder-Mackler L,et al. A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury[J]. J Orthop Sports Phys Ther2010,40(11):705-721.
[18]
冯靖,黄冬冬,陈伟杰,等. 术前预康复对前交叉韧带重建手术患者的影响[J]. 成都体育学院学报2023,49(5):80-85.
[19]
Moksnes HSnyder-Mackler LRisberg MA. Individuals with an anterior cruciate ligament-deficient knee classified as noncopers may be candidates for nonsurgical rehabilitation[J]. J Orthop Sports Phys Ther2008,38(10):586-595.
[20]
Grindem HGranan LPRisberg MA,et al. How does a combined preoperative and postoperative rehabilitation programme influence the outcome of ACL reconstruction 2 years after surgery?A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian National Knee Ligament Registry[J]. Br J Sports Med2015,49(6):385-389.
[21]
Logerstedt DGrindem HLynch A,et al. Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study[J]. Am J Sports Med2012,40(10):2348-2356.
[22]
Grindem HLogerstedt DEitzen I,et al. Single-legged hop tests as predictors of self-reported knee function in nonoperatively treated individuals with anterior cruciate ligament injury[J]. Am J Sports Med2011,39(11):2347-2354.
[23]
Granan LPBahr RSteindal K,et al. Development of a national cruciate ligament surgery registry: the Norwegian National Knee Ligament Registry[J]. Am J Sports Med2008,36(2):308-315.
[24]
崔毅鹏,李若尘,刘蔚,等. 前交叉韧带重建术后膝前疼痛的危险因素分析[J/CD]. 中华关节外科杂志(电子版)2022,16(6):690-696.
[25]
Kinzer AJenkins WUrch SE,et al. Rehabilitation following knee dislocation with lateral side injury: implementation of the knee symmetry model[J]. N Am J Sports Phys Ther2010,5(3):155-165.
[26]
Keays SLBullock-Saxton JENewcombe P,et al. The effectiveness of a pre-operative home-based physiotherapy programme for chronic anterior cruciate ligament deficiency[J]. Physiother Res Int2006,11(4):204-218.
[27]
Alshewaier SYeowell GFatoye F. The effectiveness of pre-operative exercise physiotherapy rehabilitation on the outcomes of treatment following anterior cruciate ligament injury: a systematic review[J]. Clin Rehabil2017,31(1):34-44.
[28]
张汉权,周甜甜,陈毕能,等. 前交叉韧带重建术前规范康复训练对预后的影响[J]. 中国骨与关节损伤杂志2022,37(8):847-850.
[29]
孟伟,戚世宗,何成奇. Pilon骨折围手术期加速康复的康复治疗规范[J]. 华西医学2022,37(5):765-770.
[30]
卜雨. 全膝关节置换术后足底压力对称性变化特征研究[D]. 武汉: 武汉体育学院,2023.
[31]
Brinlee AWDickenson SBHunter-Giordano A,et al. ACL reconstruction rehabilitation: clinical data,biologic healing,and criterion-based milestones to inform a return-to-sport guideline[J]. Sports Health2022,14(5):770-779.
[32]
檀志宗,李男. 运动员前交叉韧带重建术及重返赛场的康复策略[J]. 体育科研2018,39(3):76-80.
[33]
许杰. 非接触性前交叉韧带断裂患者慢性期下肢功能特点分析[D]. 成都: 成都体育学院,2022.
[34]
王元新,薛爱荣,闫磊,等. 前交叉韧带重建术后股四头肌萎缩的研究进展[J]. 河南医学研究2022,31(20):3835-3840.
[35]
Siebold RDehler CEllert T. Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction[J]. Arthroscopy2008,24(2):137-145.
[36]
卫文芳. 术前疼痛知识教育对骨科患者术后疼痛认知度及镇痛需求的影响[J]. 西南军医2017,19(3):289-292.
[37]
Lepley LKPalmieri-Smith RM. Pre-operative quadriceps activation is related to post-operative activation,not strength,in patients post-ACL reconstruction[J]. Knee Surg Sports Traumatol Arthrosc2016,24(1):236-246.
[38]
Månsson OKartus JSernert N. Pre-operative factors predicting good outcome in terms of health-related quality of life after ACL reconstruction[J]. Scand J Med Sci Sports2013,23(1):15-22.
[39]
Lowe WRWarth RJDavis EP,et al. Functional bracing after anterior cruciate ligament reconstruction: asystematic review[J]. J Am Acad Orthop Surg2017,25(3):239-249.
[40]
Glattke KETummala SVChhabra A. Anterior cruciate ligament reconstruction recovery and rehabilitation: asystematic review[J]. J Bone Joint Surg Am2022,104(8):739-754.
[41]
American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults[J]. Med Sci Sports Exerc2009,41(3):687-708.
[42]
Ramirez-Campillo RGarcía-Hermoso AMoran J,et al. The effects of plyometric jump training on physical fitness attributes in basketball players: a meta-analysis[J]. J Sport Health Sci2022,11(6):656-670.
[43]
Hartigan EAxe MJSnyder-Mackler L. Perturbation training prior to ACL reconstruction improves gait asymmetries in non-copers[J]. J Orthop Res2009,27(6):724-729.
[44]
Perry MCMorrissey MCMorrissey D,et al. Knee extensors kinetic chain training in anterior cruciate ligament deficiency[J]. Knee Surg Sports Traumatol Arthrosc2005,13(8):638-648.
[45]
周苗,李育玲. 骨科手术患者术前焦虑现状及影响因素分析[J]. 中华现代护理杂志2020,26(5):617-622.
[46]
肖颜,陶广华. 择期手术患者术前焦虑状态及其影响因素分析[J]. 护理实践与研究2023,20(1):37-40.
[47]
冉启果,钟玲,冯睿,等. 关节镜下前交叉韧带重建患者心理特征与早期康复相关性研究[J]. 世界最新医学信息文摘2019,19(36):43-44.
[48]
Li SQi MYuan W,et al. The impact of the depression and anxiety on prognosis of cervical total disc replacement[J/OL]. Spine2015,40(5):E266-E271. DOI: 10.1097/BRS.0000000000000743.
[49]
Chuang MFTung HHClinciu DL,et al. The effect of an integrated education model on anxiety and uncertainty in patients undergoing cervical disc herniation surgery[J]. Comput Methods Programs Biomed2016,133:17-23.
[50]
Christino MAFleming BCMachan JT,et al. Psychological factors associated with anterior cruciate ligament reconstruction recovery[J/OL]. Orthop J Sports Med2016,4(3):2325967116638341. DOI: 10.1177/2325967116638341.
[51]
王晓玲. 术前心理干预对择期骨科手术患者焦虑情绪的影响[J]. 保健医学研究与实践2014,11(4):14-16.
[52]
Logerstedt DLynch AAxe MJ,et al. Pre-operative quadriceps strength predicts IKDC2000 scores 6 months after anterior cruciate ligament reconstruction[J]. Knee2013,20(3):208-212.
[53]
Read PAuliffe SMWilson MG,et al. Better reporting standards are needed to enhance the quality of hop testing in the setting of ACL return to sport decisions: a narrative review[J]. Br J Sports Med2021,55(1):23-29.
[54]
Davies WTMyer GDRead PJ. Is it time we better understood the tests we are using for return to sport decision making following ACL reconstruction?A critical review of the hop tests[J]. Sports Med2020,50(3):485-495.
[55]
宋金凤,范丹丹,刘泽键,等. 膝关节前交叉韧带重建术后康复治疗进展[J]. 中国老年保健医学2023,21(4):3-8.
[56]
王盛,姜文君. 徒手肌力检查发展史及分级进展[J]. 中国康复理论与实践2015,21(6):666-669.
[57]
何渊,汪伍,王惠芳,等. 1次可重复最大力量评估方法的研究进展[J]. 中国康复医学杂志2021,36(9):1180-1183.
[58]
di Paolo SLopomo NFDella Villa F,et al. Rehabilitation and return to sport assessment after anterior cruciate ligament injury: quantifying joint kinematics during complex high-speed tasks through wearable sensors[J/OL]. Sensors2021,21(7):2331. DOI: 10.3390/s21072331.
[59]
吴宇峰,陈亮,高大伟,等. 4种物理检查方法在前交叉韧带完全断裂诊断中的应用价值[J]. 上海交通大学学报(医学版)2017,37(11):1513-1516,1512.
[60]
Webster KEFeller JA. Younger patients and men achieve higher outcome scores than older patients and women after anterior cruciate ligament reconstruction[J]. Clin Orthop Relat Res2017,475(10):2472-2480.
[61]
万丽,赵晴,陈军,等. 疼痛评估量表应用的中国专家共识(2020版)[J]. 中华疼痛学杂志2020,16(03):177-87.
[62]
Muller BYabroudi MALynch A,et al. Defining thresholds for the patient acceptable symptom state for the IKDC subjective knee form and KOOS for patients who underwent ACL reconstruction[J]. Am J Sports Med2016,44(11):2820-2826.
[63]
Ralles SAgel JObermeier M,et al. Incidence of secondary intra-articular injuries with time to anterior cruciate ligament reconstruction[J]. Am J Sports Med2015,43(6):1373-1379.
[64]
方琴,范青洪,陈伟,等. 关节镜下自体肌腱重建术手术时机对前交叉韧带损伤的疗效与安全性分析[J]. 创伤外科杂志2023,25(10):762-766.
[65]
刘凯,宋伟,阮槟,等. 前交叉韧带损伤后膝关节功能评估量表的研究进展[J]. 中国康复理论与实践2019,25(12):1395-1399.
[66]
Ingelsrud LHTerwee CBTerluin B,et al. Meaningful change scores in the knee injury and osteoarthritis outcome score in patients undergoing anterior cruciate ligament reconstruction[J]. Am J Sports Med2018,46(5):1120-1128.
[67]
Esculier JFBouyer LJDubois B,et al. Is combining gait retraining or an exercise programme with education better than education alone in treating runners with patellofemoral pain?A randomised clinical trial[J]. Br J Sports Med2018,52(10):659-666.
[1] 杨占宇, 黄艳华, 马小迪, 冯安莹, 王旼娴, 龙青燕. 本体感觉训练对踝关节周围骨折患者步行能力的改善[J]. 中华关节外科杂志(电子版), 2024, 18(04): 477-483.
[2] 高小康, 张净宇, 刘金伟, 田东牧, 胡永成, 徐卫国. 连接型人工膝关节假体运动和负重模式的演变和进展[J]. 中华关节外科杂志(电子版), 2024, 18(04): 505-516.
[3] 于威, 王艺凯, 杨文博, 孟春庆, 王洪, 黄玮. 陈旧性前交叉韧带胫骨止点撕脱骨折的诊疗进展[J]. 中华关节外科杂志(电子版), 2024, 18(04): 532-537.
[4] 赵飞鸿, 陈颖杰, 林静芳, 郑晓春, 廖燕凌. 超声引导下周围神经阻滞对髋膝关节置换术后恢复的影响[J]. 中华关节外科杂志(电子版), 2024, 18(04): 457-468.
[5] 李萍, 陈慧, 庄君龙. 快速康复外科在机器人辅助腹腔镜膀胱切除回肠造口术中的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(03): 249-253.
[6] 夏慧, 廖慧, 戴艳萍, 吴俊萍, 杨诚, 李建雄, 刘存东. 医护合作——快速康复模式在单孔腹腔镜上尿路重建围手术期的应用研究[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(03): 266-270.
[7] 许桂祥, 吴海华, 赵鸿志, 徐丽, 胡晓萍, 周世龙, 武永明, 彭新刚. 后鞘前入路腹腔镜视野下腹股沟区脂肪归属的解剖要点及临床意义[J]. 中华疝和腹壁外科杂志(电子版), 2024, 18(03): 277-281.
[8] 成紫琳, 戴明, 李建华, 马靓. 加速康复外科理念在儿童腹股沟疝围手术期的应用[J]. 中华疝和腹壁外科杂志(电子版), 2024, 18(03): 331-335.
[9] 王招荐, 曹桢, 郭小双, 靳小雷, 刘子文. 加速康复外科理念应用于腹壁重建手术的系统评价及Meta分析[J]. 中华疝和腹壁外科杂志(电子版), 2024, 18(03): 343-350.
[10] 白丽丽, 江榆, 黄亮亮, 白莹, 张敏. 作业疗法在非小细胞肺癌患者术后康复中应用分析[J]. 中华肺部疾病杂志(电子版), 2024, 17(03): 411-415.
[11] 谭佳鸿, 施茹, 赵晗, 张粉, 吴小蝶, 赵琳, 冯云. 经阴道自然腔道内镜手术在妇科良性疾病治疗中的应用[J]. 中华腔镜外科杂志(电子版), 2024, 17(03): 153-159.
[12] 冯嘉楠, 蔡磊, 何国林, 付顺军, 张成, 冯周彬, 温耀鸿, 谭洪坤, 潘明新. 腹腔镜胆总管切开探查取石一期缝合的安全性与疗效:附128例分析[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 543-550.
[13] 朱志, 张鑫炜, 谭文斐, 高梓茗, 赵睿涵, 杨野, 王世洋, 智冬梅, 赵鑫, 尹长欣, 高畅远, 王锡山, 王振宁, 李凯, 周海涛. 直肠癌经自然腔道取标本手术在日间手术中的应用[J]. 中华结直肠疾病电子杂志, 2024, 13(04): 329-334.
[14] 沈康敏, 康晓宇, 刘丽旭. Theta爆发式经颅磁刺激治疗卒中后失语的研究进展[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 171-176.
[15] 于晓光, 秦永辉, 李佳, 贾国兴, 李军, 赵振栓, 刘国彬. 人工单髁置换术治疗膝关节内侧间室骨关节炎合并前交叉韧带功能不良的近期疗效[J]. 中华临床医师杂志(电子版), 2024, 18(04): 337-342.
阅读次数
全文


摘要