背景:

對于前交叉韌帶(ACL)損傷手術(shù)和非手術(shù)治療后1年和2年的成功結(jié)果，目前尚無金標(biāo)準(zhǔn)。這限制了研究人員和臨床醫(yī)生比較和對比干預(yù)措施結(jié)果的能力。

目的:

在專家共識的基礎(chǔ)上建立一個共識，以確定ACL損傷或重建后1年和2年的成功結(jié)果。

方法:

通過電子郵件向國際運動醫(yī)學(xué)協(xié)會的成員，包括美國運動醫(yī)學(xué)骨科學(xué)會、歐洲運動創(chuàng)傷學(xué)、外科和膝關(guān)節(jié)鏡學(xué)會以及美國物理治療協(xié)會發(fā)送了一份調(diào)查。用頻率計數(shù)分析盲法反應(yīng)的趨勢。計算了總和重要性百分比(SIP)， 80%的SIP在操作上表示共識。

結(jié)果:

共獲得1779條響應(yīng)。在手術(shù)和非手術(shù)治療的六項措施上達(dá)成了共識:沒有讓步（不穩(wěn)）、患者恢復(fù)運動、股四頭肌和腘繩肌力量大于未受累肢體的90%、患者不超過輕度膝關(guān)節(jié)積液以及使用患者報告的結(jié)果(PRO)。沒有單一的PRO達(dá)成共識，但建立了關(guān)于患者表現(xiàn)的PRO的閾值評分在85到90之間。

結(jié)論:

共識確定了ACL損傷或重建后成功預(yù)后的六個重要措施。它們代表了國際功能分類的所有級別:積液、讓位、肌肉力量(身體結(jié)構(gòu)和功能)、PRO(活動和參與)和重返運動(參與)，應(yīng)包括在內(nèi)，以便在干預(yù)措施之間進(jìn)行比較。

Abstract

Background:?No gold standard exists for identifying successful outcomes 1 and 2 years after operative and non-operative management of anterior cruciate ligament (ACL) injury. This limits the ability of a researcher and clinicians to compare and contrast the results of interventions.

Purpose:?To establish a consensus based on expert consensus of measures that define successful outcomes 1 and 2 years after ACL injury or reconstruction.

Methods:?Members of international sports medicine associations, including the American Orthopaedic Society for Sports Medicine, the European Society for Sports Traumatology, Surgery, and Knee Arthroscopy and the American Physical Therapy Association, were sent a survey via email. Blinded responses were analysed for trends with frequency counts. A summed importance percentage (SIP) was calculated and 80% SIP operationally indicated consensus.

Results:?1779 responses were obtained. Consensus was achieved for six measures in operative and non-operative management: the absence of giving way, patient return to sports, quadriceps and hamstrings' strength greater than 90% of the uninvolved limb, the patient having not more than a mild knee joint effusion and using patient-reported outcomes (PRO). No single PRO achieved consensus, but threshold scores between 85 and 90 were established for PROs concerning patient performance.

Conclusions:?The consensus identified six measures important for successful outcome after ACL injury or reconstruction. These represent all levels of the International Classification of Functioning: effusion, giving way, muscle strength (body structure and function), PRO (activity and participation) and return to sport (participation), and should be included to allow for comparison between interventions.

From:

Br J Sports Med.?2015 Mar;49(5):335-42.

doi: 10.1136/bjsports-2013-092299.?

Epub 2013 Jul 23.