医学
物理医学与康复
前交叉韧带重建术
外翻
回归运动
物理疗法
运动员
荟萃分析
功能测试
梅德林
外科
前交叉韧带
内科学
政治学
法学
作者
Vikram Gill,Sailesh V. Tummala,Georgia Sullivan,Wenchao Han,Jack M. Haglin,Lisa Marks,John M. Tokish
标识
DOI:10.1016/j.arthro.2023.12.032
摘要
Purpose There remains no consensus on the best tests to use during the return-to-sport (RTS) period following ACL reconstruction (ACLR). The purpose of this study was to systematically review the relationship between functional testing at the time of RTS and short-term outcomes, such as second ACL tear and return to a preinjury level of sport, among athletes who underwent ACLR. Methods A systematic literature search was performed in MEDLINE, EMBASE, Scopus, and Web of Science to identify studies examining athletes who underwent functional RTS testing and were followed for at least 12 months following ACLR. Studies were screened by two reviewers. A standardized template was used to extract information regarding study characteristics, ACLR information, functional test results, and risk factors associated with retear or reduced RTS. Results Of the 937 studies identified, 22 met the inclusion criteria. The average time between ACLR and RTS testing was 8.5 months. Single leg hop for distance performance had no association with retear risk in any study and no association with RTS rates in most studies. Quadriceps strength had conflicting results in relation to retear risk, while having no relationship with RTS rates. Rates of reinjury and RTS were similar between patients who passed and did not pass combined hop and strength batteries. Asymmetric knee extension and hip moments, along with increased knee valgus and knee flexion angles demonstrated increased risk of retear. Conclusions Individual hop and strength tests that are often used in return-to-sport protocols following ACLR may have limited and inconsistent value in predicting ACL reinjury and reduced return to sport when used in isolation. Combined hop and strength test batteries also demonstrate low sensitivity and negative predictive value, highlighting conflicting evidence to suggest RTS testing algorithm superiority. Biomechanical assessment is promising for stratifying ACL reinjury risk, but further research is necessary.
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