急性跟腱断裂术后早期功能锻炼的研究进展

Research progress of early postoperative rehabilitation for acute Achilles tendon rupture after surgical repair

目的总结急性跟腱断裂术后早期功能锻炼的研究进展。方法查阅近年来国内外关于急性跟腱断裂术后早期功能锻炼的临床随机对照研究和系统评价,并进行分析总结。结果急性跟腱断裂术后早期功能锻炼主要包括早期屈伸活动、早期负重、早期负重联合屈伸活动。临床随机对照研究结果显示,术后早期屈伸活动、早期负重或者两者联合,患者恢复效果与早期固定相似或优于早期固定。系统评价结果显示,早期功能锻炼有利于跟腱功能恢复,并且缩短了术后恢复时间,不会增加术后再断裂等并发症发生率。结论急性跟腱断裂术后早期在支具保护下行功能锻炼有利于早期功能恢复,但早期活动和负重的方式和最佳时机尚无统一标准,需要进一步研究。

Objective To summarize the latest research progress of early postoperative rehabilitation for acute Achilles tendon rupture after surgical repair. Methods The high-quality randomized controlled trials and systematic reviews/meta-analyses regarding early postoperative rehabilitation for acute Achilles tendon rupture in recent years were reviewed. Results There are three functional rehabilitations after acute Achilles tendon rupture surgery, including early postoperative mobilization, early weight-bearing with immobilization, and early weight-bearing combined with mobilization. The results of randomized controlled trials show that the effectiveness of early postoperative rehabilitation is similar or better than the early postoperative immobilization. The results of systematic reviews/meta-analyses show that the early postoperative rehabilitation is beneficial to the early function recovery of the Achilles tendon, can reduce the time for functional recovery, and do not adversely affect the outcomes. Conclusion Early postoperative rehabilitation is beneficial to the functional recovery, and do not increase postoperative complications. There is still no uniform protocol of early postoperative rehabilitation and the timing of weight-bearing, and further studies are needed in the future.