前交叉韧带损伤后手术及重返运动时机的选择

The timing of operation and return to sport after ACL injury

前交叉韧带(ACL)损伤是一种常见的严重运动损伤,其损伤后会影响膝关节的结构及功能稳定性,若不及时进行正确的治疗可能会引起膝关节内半月板、软骨等其他结构进一步损伤,增大骨性关节炎的发病概率.目前对于前交叉韧带断裂的处理,国内外学者已基本达成共识,采用自体移植物重建前交叉韧带具有良好的临床效果.但对于手术时机的选择,国内外学者之间仍存在争议,国内学者多重视急性期手术,国外学者倾向于延期手术. ACL重建后重返运动的时间越晚,二次损伤的概率越小. ACL重建后可以选择肌力、本体感觉、神经肌肉控制、肌肉发力率、心理因素等指标综合评价,为ACL重建后何时重返运动提供科学的依据.

The injury of anterior cruciate ligament(ACL)is the most common serious sports injuries which may affect the structure and functional stability of the knee.If the correct treatment is not done in time,it may cause further damage to the meniscus,cartilage and other structures in the knee and increase the incidence of osteoarthritis.Now,the researchers at home and abroad have reached an agreement that the best way to treat the ACL rupture is anterior cruciate ligament reconstruct with auto graft,which has good clinical effect.However,the timing of the operation still remains controversial between domestic and international scholars.Domestic scholars tend to the acute stage operation,and foreign scholars tend to postpone the operation.The later return to sport after ACLR,the less likely it is to suffer a secondary injury.After ACL reconstruction,muscle strength,proprioception,neuromuscular control,psychological factors and so on can be selected to determine the most scientific time to return to sport after ACLR.