摘要
目的:总结并分析前交叉韧带重建术失败的原因,对前交叉韧带翻修的术前计划及术后的见解加以评论,重点强调翻修与初次重建术后康复治疗的不同点。资料来源:应用计算机检索Medline1980-01/2004-12关于前交叉韧带重建、翻修及康复的文章。检索词“ACL,reconstruction,revision,rehabil-itation”并限定文章的语种类为English。同时利用计算机检索中国期刊全文数据库1989-01/2004-12的相关文章,限定文章语言种类为中文,检索词“前交叉韧带,重建,翻修,康复”。资料选择:对资料进行初审,纳入标准:①关于前交叉韧带初次重建术后的康复、失败的原因,前交叉韧带翻修的术前计划、术后康复。②对具体事件的回顾调查研究。排除标准:排除重复性研究。资料提炼:共收集到符合上述要求的文献69篇,排除44篇重复性研究。25篇符合纳入标准:其中9篇关于前交叉韧带翻修,4篇关于前交叉韧带康复,12篇关于前交叉韧带重建。资料综合:前交叉韧带重建术失败的原因主要涉及手术技术、术后康复、患者对手术的期望度及顺应性、伴随的其他韧带或关节软骨的损伤程度以及移植物问题等方面,康复重点是早期活动、被动完全伸膝、负重及功能锻炼以改善患者的总体预后。翻修术后的康复计划因人而异。结论:前交叉韧带重建术失败的原因是多方面的,翻修术及术后的康复计划,目的是重建有功能的膝关节,使之具有足够的稳定性以满足日常生活中各种活动的需要。
OBJECTIVE：To summarize and analyze the causes for the failure of anterior cruciate ligament （ACL） reconstruction surgery, evaluate the pre-operation design and the post-operation opinion of ACL repair and mainly stress the different point of rehabilitative therapy of repair and first reconstruction.
DATA SOURCES： The relevant articles on principles of anterior cruciate ligament reconstruction, revision surgery and postoperative rehabilitation were searched in Medline database between January 1980 and December 2004 with the keywords of ＂ACL,reconstruction ,revision ,rehabilitation＂ in English. Meanwhile, we also searched in China Journal Full-text Database （CJFD） for related articles with the key words ＂ACL, reconstruction, revision, rehabilitation＂ published between Januau 1989 and December 2004 in Chinese. STUDY SELECTION： The data were selected primarily. Inclusive criteria：①Articles on postoperative rehabilitation and eause of failure after the first reconstruction on ACL, preoperative planning and postoperative rehabilitation for ACL revision.②Articles on retrospective study of incidents. Exclusive criteria： duplicate studies were excluded.
DATA EXTRACTION： There were 69 literatures accorded with the above-mentioned request. Forty-four of them were exeluded due to the repetition of the same research. Twenty-five artieles were in accordance with the inclusive criteria, in which 9 were about ACL revision, 4 were about ACL rehabilitation, 12 were about ACL reconstruction.
DATA SYNTHESIS： The reason of failure of ACL reeonstruction may be influenced by many factors such as： surgical technique, postoperative rehabilitation, motivation and compliance of the patient, the identification and presence of associated ligamentous or chondral injury, and the graft material, etc. The foundation of primary ACL reeonstruction rehabilitation today had focused on early motion, early and full passive knee extension, early weight-bearing, and funetional exercises to improve the patient＇s overall outcome. Rehabilitation following revision surgery must be individualized depending on a variety of factors.
CONCLUSION： The causes for the failure of ACL reconstruction are versatile. The goal of revision surgery and rehabilitation is to recreate a functional knee that is stable for various activities of daily living.
出处
《中国临床康复》
CAS
CSCD
北大核心
2006年第4期159-161,共3页
Chinese Journal of Clinical Rehabilitation
