摘要
背景:通常需要将主观评分和客观评价标准联合使用才能更准确和全面地对前交叉韧带损伤重建患者的膝关节功能进行评估。目的:回顾前交叉韧带重建后有效性和安全性评价标准的演变趋势,分析主观与客观测量工具使用的动态演变。方法:对PubMed与Embase数据库进行了系统性检索,检索时限为建库至2023-08-22,识别包含前交叉韧带重建后评估膝关节功能的研究,最终筛选符合纳入标准的研究文献共136篇,提取文中使用的各类评价标准的使用频率,最后运用Origin 2025软件分析其随时间的变化。结果与结论:①在1990-2005年间,客观评价标准应用较为广泛;自2005年起,以患者报告结果测量为代表的主观评分的使用比例迅速上升,且于2009年起使用频率显著超过客观评价标准;②其中早期以Lysholm量表、Tegner活动评分占主导地位,后期国际膝关节文献委员会主观膝关节评分、膝关节损伤和骨关节炎结局评分及前交叉韧带受伤后恢复运动量表逐渐成为主要主观工具;③此外,在客观评价方面,KT1000/2000关节测量仪、Lachman试验和跳跃试验的应用保持相对稳定,但总体处于下降趋势;④提示前交叉韧带重建后有效性和安全性评估标准经历了从以客观膝关节稳定性为主向以患者主观体验为中心的转变;⑤此文首次通过量化数据揭示当今主流评价工具的动态演变过程,指出当前临床实践强调主客观评价标准结合评估,推荐的组合为:国际膝关节文献委员会主观膝关节评分或膝关节损伤和骨关节炎结局评分+前交叉韧带受伤后恢复运动量表+KT1000/2000或跳跃试验,以全面反映膝关节功能恢复与患者感知结果,为未来建立综合评估方式提供了实证基础。
BACKGROUND:A combination of subjective and objective evaluation criteria is often required to more accurately and comprehensively assess knee function in patients undergoing anterior cruciate ligament reconstruction.OBJECTIVE:To review the evolving trends in effectiveness and safety evaluation criteria after anterior cruciate ligament reconstruction and analyze the dynamic shift in the use of subjective and objective assessment tools.METHODS:A systematic search of PubMed and Embase was conducted up to August 22,2023 to identify studies assessing knee function after anterior cruciate ligament reconstruction.A total of 136 eligible studies meeting the inclusion criteria were included.The frequency of each evaluation standard was extracted and analyzed over time using Origin 2025 software.RESULTS AND CONCLUSION:(1)Between 1990 and 2005,objective measures were widely applied.Since 2005,subjective scoring systems,particularly patientreported outcome measures,have increased sharply,surpassing objective standards in frequency from 2009 onward.(2)Early use was dominated by the Lysholm scale and Tegner activity score,while the International Knee Documentation Committee-Subjective Knee Form,Knee Injury and Osteoarthritis Outcome Score,and anterior cruciate ligament–return to sport after injury gradually emerged as the main tools in later years.(3)In contrast,objective assessments such as the KT1000/2000 arthrometer,Lachman test,and hop tests remained relatively stable but showed an overall downward trend.(4)This suggests that the evaluation criteria for the effectiveness and safety of anterior cruciate ligament reconstruction have shifted from a primary focus on objective knee stability to an emphasis on patient-reported experiences.(5)This study is the first to quantitatively reveal the dynamic evolution of mainstream assessment tools.Current clinical practice highlights the integration of subjective and objective measures,and we recommend the following combination:International Knee Documentation Committee-Subjective Knee Form or Knee Injury and Osteoarthritis Outcome Score,together with anterior cruciate ligament–return to sport after injury,plus either the KT1000/2000 arthrometer or hop tests.Such a framework provides a more comprehensive reflection of both functional recovery and patient perception,offering an evidence-based foundation for the development of future integrated evaluation systems.
作者
李成科
高苗苗
雷蕾
马荣星
张净宇
胡永成
Li Chengke;Gao Miaomiao;Lei Lei;Ma Rongxing;Zhang Jingyu;Hu Yongcheng(Tianjin Hospital of Tianjin University,Tianjin 300211,China;Tianjin Medical University,Tianjin 300211,China)
出处
《中国组织工程研究》
北大核心
2026年第21期5605-5613,共9页
Chinese Journal of Tissue Engineering Research
基金
京津冀基础研究合作专项(22JCZXJC00130),项目负责人:张净宇
天津市计量科技项目(2024TJMT039),项目负责人:张净宇
天津市天津医院科技基金项目(TJYY2401),项目参与人:张净宇
天津市卫生健康委员会科技项目(TJWJ2024MS027),项目参与人:张净宇。
关键词
前交叉韧带损伤
前交叉韧带重建
主观评价标准
客观评价标准
动态演变
趋势分析
anterior cruciate ligament injury
anterior cruciate ligament reconstruction
subjective evaluation criteria
objective evaluation criteria
dynamic evolution
trend analysis
