Interpretation and clinical application of international guidelines on management of anterior cruciate ligament injuries

doi:10.3877/cma.j.issn.1674-134X.2021.06.011

Abstract

Abstract:

Anterior cruciate ligament (ACL) injury has always been the most common sport injury of the knee. It is necessary to provide timely and effective medical treatment to patients suffering anterior cruciate ligament injury. However, clinicians have confusion in diagnosis of anterior cruciate ligament injury, surgical indications, surgical methods, graft types, rehabilitation program as well as return-to-sport tests. Thus s series of ACL treatment guidelines and consensuses have been published by some international research organizations based on the available knowledge. Besides, there are inheritance, development and even controversies among these guidelines. In this article, treatment suggestions to controversial clinical issues were summarized after thoroughly interpretation and analysis of these guidelines. It is hoped to provide reference for clinicians.

Key words: Anterior cruciate ligament, Practice guideline, Review

Tianping Zhou, Yihong Xu, Weidong Xu. Interpretation and clinical application of international guidelines on management of anterior cruciate ligament injuries[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(06): 718-724.

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References 43

[1]	Granan LP, Bahr R, Steindal K, et al. Development of a National cruciate ligament surgery registry: the Norwegian National Knee Ligament Registry[J]. Am J Sports Med, 2008, 36(2): 308-315.
[2]	Brambilla L, Pulici L, Carimati G, et al. Prevalence of associated lesions in anterior cruciate ligament reconstruction: correlation with surgical timing and with patient age, sex, and body mass index[J]. Am J Sports Med, 2015, 43(12): 2966-2973.
[3]	Diermeier T, Rothrauff BB, Engebretsen L, et al. Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(8): 2390-2402.
[4]	Svantesson E, Hamrin Senorski E, Webster KE, et al. Clinical outcomes after anterior cruciate ligament injury: Panther Symposium ACL Injury Clinical Outcomes Consensus Group[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(8): 2415-2434.
[5]	Meredith SJ, Rauer T, Chmielewski TL, et al. Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group[J]. J ISAKOS, 2021, 6(3): 138-146.
[6]	Ishibashi Y, Adachi N, Koga H, et al. Japanese orthopaedic association (JOA) clinical practice guidelines on the management of anterior cruciate ligament injury-secondary publication[J]. J Orthop Sci, 2020, 25(1): 6-45.
[7]	Bait C, Randelli P, Compagnoni R, et al. Italian consensus statement for the use of allografts in ACL reconstructive surgery[J]. Knee Surg Sports Traumatol Arthrosc, 2019, 27(6): 1873-1881.
[8]	Van MN, Van CR, Brooijmans F, et al. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus[J]. Br J Sports Med, 2016, 50(24): 1506-1515.
[9]	Shea KG, Carey JL, Richmond J, et al. The American academy of orthopaedic surgeons evidence-based guideline on management of anterior cruciate ligament injuries[J]. J Bone Joint Surg Am, 2015, 97(8): 672-674.
[10]	Wright RW, Haas AK, Anderson J, et al. Anterior cruciate ligament reconstruction rehabilitation: MOON guidelines[J]. Sports Health, 2015, 7(3): 239-243.
[11]	Meuffels DE, Poldervaart MT, Diercks RL, et al. Guideline on anterior cruciate ligament injury[J]. Acta Orthop, 2012, 83(4): 379-386.
[12]	Stanley LE, Kerr ZY, Dompier TP, et al. Sex differences in the incidence of anterior cruciate ligament, medial collateral ligament, and meniscal injuries in collegiate and high school sports: 2009-2010 through 2013-2014[J]. Am J Sports Med, 2016, 44(6): 1565-1572.
[13]	Lansdown D, Ma CB. The influence of tibial and femoral bone morphology on knee kinematics in the anterior cruciate ligament injured knee[J]. Clin Sports Med, 2018, 37(1): 127-136.
[14]	Dare DM, Fabricant PD, Mccarthy MM, et al. Increased lateral tibial slope is a risk factor for pediatric anterior cruciate ligament injury: an MRI-based case-control study of 152 patients[J]. Am J Sports Med, 2015, 43(7): 1632-1639.
[15]	Fahim SM, Dhawan T, Jagadeesh N, et al. The relationship of anterior cruciate ligament injuries with MRI based calculation of femoral notch width, notch width index, notch shape - a randomized control study[J/OL]. J Clin Orthop Trauma, 2021, 17: 5-10. DOI: 10.1016/j.jcot.2021.01.006.
[16]	Al-Saeed O, Brown M, Athyal R, et al. Association of femoral intercondylar notch morphology, width index and the risk of anterior cruciate ligament injury[J]. Knee Surg Sports Traumatol Arthrosc, 2013, 21(3): 678-682.
[17]	Zebis MK, Andersen LL, Brandt M, et al. Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes: a randomised controlled trial[J]. Br J Sports Med, 2016, 50(9): 552-557.
[18]	Westin M, Reeds-Lundqvist S, Werner S. The correlation between anterior cruciate ligament injury in elite alpine skiers and their parents[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(3): 697-701.
[19]	Dischiavi SL, Wright AA, Heller RA, et al. Do ACL injury risk reduction exercises reflect common injury mechanisms? A scoping review of injury prevention programs[J/OL]. Sports Health, 2021: 19417381211037966. DOI: 10.1177/19417381211037966.
[20]	Song GY, Ni QK, Zheng T, et al. Slope-reducing tibial osteotomy combined with primary anterior cruciate ligament reconstruction produces improved knee stability in patients with steep posterior tibial slope, excessive anterior tibial subluxation in extension, and chronic meniscal posterior horn tears[J]. Am J Sports Med, 2020, 48(14): 3486-3494.
[21]	Leblanc MC, Kowalczuk M, Andruszkiewicz N, et al. Diagnostic accuracy of physical examination for anterior knee instability: a systematic review[J]. Knee Surg Sports Traumatol Arthrosc, 2015, 23(10): 2805-2813.
[22]	Zhao M, Zhou Y, Chang J, et al. The accuracy of MRI in the diagnosis of anterior cruciate ligament injury[J/OL]. Ann Transl Med, 2020, 8(24): 1657. DOI: 10.21037/atm-20-7391.
[23]	Grevnerts HT, Sonesson S, Gauffin H, et al. Decision making for treatment after ACL injury from an orthopaedic surgeon and patient perspective: results from the NACOX study[J/OL]. Orthop J Sports Med, 2021, 9(4): 23259671211005090. DOI: 10.1177/23259671211005090.
[24]	Hoogeslag R, Buitenhuis MB, Brouwer RW, et al. Standard MRI May not predict specific acute anterior cruciate ligament rupture characteristics[J/OL]. Orthop J Sports Med, 2021, 9(3): 2325967121992472. DOI: 10.1177/2325967121992472.
[25]	曾小龙，钟国庆，黄文汉，等．基于运动捕捉膝关节运动分析及临床常规评估进展[J/CD]．中华关节外科杂志(电子版)，2021，15(3)：334-338.
[26]	Konrads C, Döbele S, Ateschrang A, et al. Outcome of anterior cruciate ligament reconstruction in children and adolescents: a retrospective study[J/OL]. J Clin Orthop Trauma, 2021, 13：46-49. DOI: 10.1016/j.jcot.2020.08.022.
[27]	Pennock A, Murphy MM, Wu M. Anterior cruciate ligament reconstruction in skeletally immature patients[J]. Curr Rev Musculoskelet Med, 2016, 9(4): 445-453.
[28]	Chalmers PN, Mall NA, Moric M, et al. Does ACL Reconstruction alter natural history? A systematic literature review of long-term outcomes[J]. J Bone Joint Surg Am, 2014, 96(4): 292-300.
[29]	Tan CW, Hsu WH, Yu P, et al. Anterior cruciate ligament reconstruction in patients older than 50 years: a systematic review and meta-analysis[J/OL]. Orthop J Sports Med, 2020, 8(4): 2325967120915698. DOI: 10.1177/2325967120915698.
[30]	Kim SH, Seo HJ, Seo DW, et al. Analysis of risk factors for ramp lesions associated with anterior cruciate ligament injury[J]. Am J Sports Med, 2020, 48(7): 1673-1681.
[31]	Tashiro Y, Okazaki K, Murakami K, et al. Anterolateral rotatory instability in vivo correlates tunnel position after anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft[J]. World J Orthop, 2017, 8(12): 913-921.
[32]	Chen L, Wu Y, Lin G, et al. Graft bending angle affects allograft tendon maturity early after anterior cruciate ligament reconstruction[J]. Knee Surg Sports Traumatol Arthrosc, 2018, 26(10)：3048-3054.
[33]	Arnold MP, Calcei JG, Vogel N, et al. ACL study group survey reveals the evolution of anterior cruciate ligament reconstruction graft choice over the past three decades[J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(11): 3871-3876.
[34]	Horstmann H, Petri M, Tegtbur U, et al. Quadriceps and hamstring tendon autografts in ACL reconstruction yield comparably good results in a prospective, randomized controlled trial[J/OL]. Arch Orthop Trauma Surg, 2021. DOI: 10.1007/s00402-021-03862-8.
[35]	Widner M, Dunleavy M, Lynch S. Outcomes following ACL reconstruction based on graft type: are all grafts equivalent？[J]. Curr Rev Musculoskelet Med, 2019, 12(4): 460-465.
[36]	Kitaguchi T, Tanaka Y, Takeshita S, et al. Preoperative quadriceps strength as a predictor of return to sports after anterior cruciate ligament reconstruction in competitive athletes[J/OL]. Phys Ther Sport, 2020, 45: 7-13. DOI: 10.1016/j.ptsp.2020.06.001.
[37]	Carter HM, Littlewood C, Webster KE, et al. The effectiveness of preoperative rehabilitation programmes on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction: a systematic review[J/OL]. BMC Musculoskelet Disord, 2020, 21(1): 647. DOI: 10.1186/s12891-020-03676-6.
[38]	Cristiani R, Mikkelsen C, Wange P, et al. Autograft type affects muscle strength and hop performance after ACL reconstruction. A randomised controlled trial comparing patellar tendon and hamstring tendon autografts with standard or accelerated rehabilitation[J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(9): 3025-3036.
[39]	Wu J, Kator JL, Zarro M, et al. Rehabilitation principles to consider for anterior cruciate ligament repair[J/OL]. Sports Health, 2021: 19417381211032949. DOI: 10.1177/19417381211032949.
[40]	van groningen B, van Der Steen MC, Janssen DM, et al. Assessment of graft maturity after anterior cruciate ligament Reconstruction using autografts: a systematic review of biopsy and magnetic resonance imaging studies[J]. Arthrosc Sports Med Rehabil, 2020, 2(4): e377-e388.
[41]	MOON Group, Everhart JS, Jones MH, et al. The clinical radiographic incidence of posttraumatic osteoarthritis 10 years after anterior cruciate ligament reconstruction: data from the MOON nested cohort[J]. Am J Sports Med, 2021, 49(5): 1251-1261.
[42]	Baron JE, Duchman KR, Wolf BR, et al. PROMIS is a valid patient-reported outcome measure for patients undergoing ACL reconstruction with multi-ligament knee reconstruction and repair procedures[J]. Knee, 2021, 28: 294-299.
[43]	Tortoli E, Francini L, Giovannico G, et al. Translation, cross-cultural adaptation and validation of the Italian version of the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2020. DOI: 10.1007/s00167-020-06169-0.

时间	机构/组织	题目	主要内容
2020	美洲豹研讨会ACL共识小组(The Panther Symposium ACL Treatment Consensus Group)	Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group	前交叉韧带重建手术指征相关问题
2020	美洲豹研讨会ACL共识小组	Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group	前交叉韧带损伤的临床结局评估相关问题
2020	美洲豹研讨会ACL共识小组	Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group	前交叉韧带损伤后重返运动相关问题
2019	日本骨科协会(Japanese Orthopaedic Association，JOA)	Japanese Orthopaedic Association 2019 guidelines for anterior cruciate ligament injuries (3rd edition)	ACL损伤的危险因素、诊断、评估、治疗及康复相关问题
2018	意大利关节镜，膝关节，上肢，运动，软骨和骨科学会(Italian Society of Arthroscopy, Knee, Upper Limb, Sports, Cartilage and Orthopaedic Technologies, SIGASCOT)	Italian consensus statement for the use of allografts in ACL reconstructive surgery	ACL重建中异体肌腱移植物的应用问题
2016	荷兰皇家理疗学会(The Royal Dutch Society for Physical Therapy，KNGF)	Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus	ACL损伤及重建后康复相关问题
2015	美国骨科学会(The American Academy Of Orthopaedic Surgery, AAOS)	The American Academy of Orthopaedic Surgeons Evidence-Based Guideline on Management of Anterior Cruciate Ligament Injuries	ACL损伤处理的基本原则问题
2014	骨科多中心协作网(Multicenter Orthopaedic Outcomes Network, MOON)	Anterior Cruciate Ligament Reconstruction Rehabilitation: MOON Guidelines	ACL重建术后康复问题
2012	荷兰骨科协会(Dutch Orthopaedic Association，NOV)	Guideline on anterior cruciate ligament injury A multidisciplinary review by the Dutch Orthopaedic Association	ACL损伤的诊断及治疗问题

时间	机构/组织	题目	主要内容
2020	美洲豹研讨会ACL共识小组(The Panther Symposium ACL Treatment Consensus Group)	Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group	前交叉韧带重建手术指征相关问题
2020	美洲豹研讨会ACL共识小组	Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group	前交叉韧带损伤的临床结局评估相关问题
2020	美洲豹研讨会ACL共识小组	Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group	前交叉韧带损伤后重返运动相关问题
2019	日本骨科协会(Japanese Orthopaedic Association，JOA)	Japanese Orthopaedic Association 2019 guidelines for anterior cruciate ligament injuries (3rd edition)	ACL损伤的危险因素、诊断、评估、治疗及康复相关问题
2018	意大利关节镜，膝关节，上肢，运动，软骨和骨科学会(Italian Society of Arthroscopy, Knee, Upper Limb, Sports, Cartilage and Orthopaedic Technologies, SIGASCOT)	Italian consensus statement for the use of allografts in ACL reconstructive surgery	ACL重建中异体肌腱移植物的应用问题
2016	荷兰皇家理疗学会(The Royal Dutch Society for Physical Therapy，KNGF)	Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus	ACL损伤及重建后康复相关问题
2015	美国骨科学会(The American Academy Of Orthopaedic Surgery, AAOS)	The American Academy of Orthopaedic Surgeons Evidence-Based Guideline on Management of Anterior Cruciate Ligament Injuries	ACL损伤处理的基本原则问题
2014	骨科多中心协作网(Multicenter Orthopaedic Outcomes Network, MOON)	Anterior Cruciate Ligament Reconstruction Rehabilitation: MOON Guidelines	ACL重建术后康复问题
2012	荷兰骨科协会(Dutch Orthopaedic Association，NOV)	Guideline on anterior cruciate ligament injury A multidisciplinary review by the Dutch Orthopaedic Association	ACL损伤的诊断及治疗问题

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