摘要
随着群众体育活动的日益普及,前十字韧带(anterior cruciate ligament,ACL)损伤的发生率显著上升,对患者的运动能力和膝关节功能造成严重影响。尽管ACL重建手术是目前治疗ACL损伤的主要方法,但术后运动恢复率低和远期骨关节炎发病率高的问题仍然存在。随着对ACL损伤愈合机制的深入理解、手术技术的不断进步以及辅助固定材料的创新,初次修复技术因其微创化和保留原有韧带组织的特点而重新受到重视,为符合手术指征的ACL损伤患者提供了重建手术之外的治疗选择。然而,国内外医生在ACL初次修复的临床实践上尚缺乏统一规范和指导原则。因此,由中华医学会运动医疗分会膝关节学组和中国医师协会运动医学医师分会共同发起,采取改良Delphi法,最终形成11项推荐建议。其中推荐意见1为临床可行性,意见2~3为技术优势、意见4为诊断和评估方法、意见5~8为手术适应证,意见9为手术方法,意见10~11为康复策略。共识的制订旨在丰富ACL损伤的治疗体系,并为ACL初次修复的临床实践提供指导。
The incidence of anterior cruciate ligament(ACL)injuries is increasing with more and more people joining sports,which severely affects sports ability and knee joint function.Although ACL reconstruction surgery remains the fundamental treatment,low rates of return-to-sports and high rates of osteoarthritis in long term still exist.With a deep understanding of the healing mechanisms of ACL injuries,advancement of surgical techniques and emergent of innovative fixation materials,primary ACL repair techniques are regaining attention due to minimal invasion and the preservation of the injured ACL,offering a second option for certain group of patients.However,no standards or treatment guidelines for primary ACL repair were published both home and abroad.Therefore,the Knee Group of Chinese Society of Sports Medicine and Sports Medicine Doctor Society of Chinese Medical Doctor Association have jointly initiated the establishment of 1l recommendations using the modified Delphi method.Among them,recommendation 1 is for clinical feasibility;recommendations 2-3 for technical advantages;recommendation 4 for diagnostic and evaluation methods;recommendations 5-8 forl surgical indications;recommendation 9 for surgical techniques;and recommendations 10-11 for rehabilitation strategies.The consensus is intended to enrich the treatment system for ACL injuries and provide guidance for primary ACL repair.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2024年第19期1255-1264,共10页
Chinese Journal of Orthopaedics
基金
上海市体育科技"备战攻关"项目(24J001)。
关键词
膝关节
关节镜检查
前交叉韧带修复
共识
Knee joint
Arthroscopy
Anterior cruciate ligament repair
Consensus
