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中华关节外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (06) : 718 -724. doi: 10.3877/cma.j.issn.1674-134X.2021.06.011

所属专题: 指南共识

综述

前交叉韧带损伤处理相关国际指南解读及其临床应用
周天平1, 徐一宏1, 徐卫东1,()   
  1. 1. 200433 上海,海军军医大学附属长海医院关节骨病外科
  • 收稿日期:2021-07-09 出版日期:2021-12-01
  • 通信作者: 徐卫东

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

Tianping Zhou1, Yihong Xu1, Weidong Xu1,()   

  1. 1. Department of Orthopedics, Changhai Hospital, The Navy Medical University, Shanghai 200433, China
  • Received:2021-07-09 Published:2021-12-01
  • Corresponding author: Weidong Xu
引用本文:

周天平, 徐一宏, 徐卫东. 前交叉韧带损伤处理相关国际指南解读及其临床应用[J/OL]. 中华关节外科杂志(电子版), 2021, 15(06): 718-724.

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

前交叉韧带损伤是一种常见的膝关节运动损伤。前交叉韧带损伤后的病人往往需要及时、有效的医学干预。但是目前临床医生在前交叉韧带损伤诊断、手术指征选择、手术方式、移植物类型、术后康复方案以及重返运动评估方面仍然存在较大困惑与争议。因此近年来国际权威研究机构和组织纷纷发布了基于当前研究水平的前交叉韧带损伤的处理指南或共识。这些指南之间既有继承又有发展,甚至有冲突之处。本研究通过对这些指南的系统解读与分析总结,归纳出目前临床上主要研究问题的最佳处理建议,为临床医生提供借鉴。

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.

表1 ACL损伤相关指南及其主要内容
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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