PDF(Pubmed)
Abstract：
UNASSIGNED: Anterior cruciate ligament (ACL) rupture is a prevalent sports injury with rising rates attributed to increased population participation in sports activities. ACL rupture can lead to severe knee complications including cartilage damage, torn meniscus, and osteoarthritis. Current treatment options include conservative measures and surgical interventions. However, debates persist regarding the optimal approach.
UNASSIGNED: This analysis intended to compare the function, knee stability, and incidence rate of secondary surgery between conservative and surgical treatments in ACL rupture patients.
UNASSIGNED: A systematic search was performed via Embase, Ovid Medline, PubMed, Cochrane Library, Web of Science, and Google Scholar for reporting outcomes of conservative and surgical treatments after ACL rupture. The outcomes included patient-reported outcome measures (PROMs), knee stability, the need for secondary meniscal surgery, delayed ACL reconstruction surgery, and revision ACL reconstruction surgery. Outcomes were analyzed using mean differences or odd ratios (OR) with 95 % CIs.
UNASSIGNED: 11 studies were included with 1516 patients. For PROMs, our evidence indicated no differences in KOOS Pain, KOOS Symptoms, KOOS Sport/Rec, KOOS ADL, and KOOS QOL. (all p > 0.05). for knee stability, pivot shift (OR, 0.14; p < 0.001), Lachman test (OR, 0.06; p < 0.001), and tibia translation (p < 0.001) were evaluated, and the available evidence favored surgical treatment over conservative treatment. For the incidence rate of any secondary surgery after the first diagnosis, the surgical group showed a lower rate of meniscal surgery with statistical significance (OR, 0.37; p < 0.001). The average rate of revision ACL reconstruction is 5.80 %, while the rate of delayed ACL reconstruction after conservative treatment is 18.51 %.
UNASSIGNED: Currently, there is insufficient empirical evidence to advocate a systematic surgical reconstruction for any patient who tore his ACL. This review found no differences in function outcomes between conservative and surgical treatments. Regarding knee stability and secondary meniscal surgery, the results prefer the surgical treatments. The occurrence rate of revision and delayed ACL reconstruction are non-negligible factors that must be fully understood by both surgeons and patients before choosing a suitable treatment.
UNASSIGNED: This analysis intended to compare the function, knee stability, and incidence rate of secondary surgery between conservative and surgical treatments in ACL rupture patients.
UNASSIGNED: A systematic search was performed via Embase, Ovid Medline, PubMed, Cochrane Library, Web of Science, and Google Scholar for reporting outcomes of conservative and surgical treatments after ACL rupture. The outcomes included patient-reported outcome measures (PROMs), knee stability, the need for secondary meniscal surgery, delayed ACL reconstruction surgery, and revision ACL reconstruction surgery. Outcomes were analyzed using mean differences or odd ratios (OR) with 95 % CIs.
UNASSIGNED: 11 studies were included with 1516 patients. For PROMs, our evidence indicated no differences in KOOS Pain, KOOS Symptoms, KOOS Sport/Rec, KOOS ADL, and KOOS QOL. (all p > 0.05). for knee stability, pivot shift (OR, 0.14; p < 0.001), Lachman test (OR, 0.06; p < 0.001), and tibia translation (p < 0.001) were evaluated, and the available evidence favored surgical treatment over conservative treatment. For the incidence rate of any secondary surgery after the first diagnosis, the surgical group showed a lower rate of meniscal surgery with statistical significance (OR, 0.37; p < 0.001). The average rate of revision ACL reconstruction is 5.80 %, while the rate of delayed ACL reconstruction after conservative treatment is 18.51 %.
UNASSIGNED: Currently, there is insufficient empirical evidence to advocate a systematic surgical reconstruction for any patient who tore his ACL. This review found no differences in function outcomes between conservative and surgical treatments. Regarding knee stability and secondary meniscal surgery, the results prefer the surgical treatments. The occurrence rate of revision and delayed ACL reconstruction are non-negligible factors that must be fully understood by both surgeons and patients before choosing a suitable treatment.
摘要：
■前交叉韧带（ACL）断裂是一种普遍的运动损伤，其发生率上升归因于人口参与体育活动的增加。ACL断裂可导致严重的膝关节并发症，包括软骨损伤，半月板撕裂,和骨关节炎。目前的治疗选择包括保守措施和手术干预。然而,关于最佳方法的辩论仍在继续。
■此分析旨在比较功能，膝关节稳定性,ACL断裂患者保守治疗和手术治疗之间的二次手术发生率。
■通过Embase进行了系统搜索，OvidMedline,PubMed,科克伦图书馆,WebofScience,和谷歌学者报告ACL破裂后保守和手术治疗的结果。结果包括患者报告的结果测量(PROMs)，膝关节稳定性,需要二次半月板手术，延迟ACL重建手术，和修正ACL重建手术。使用平均差异或奇数比(OR)和95%CI分析结果。
■11项研究纳入1516例患者。对于PROM，我们的证据表明KOOS疼痛没有差异，KOOS症状,KOOSSport/Rec,KOOSADL,和KOOSQOL。(均p>0.05)。为了膝盖的稳定性，枢轴移位(或,0.14；p<0.001)，拉赫曼测试(或，0.06;p<0.001)，和胫骨平移(p<0.001)进行了评估，现有证据支持手术治疗而不是保守治疗。对于首次诊断后任何二次手术的发生率，手术组半月板手术率较低，具有统计学意义(OR，0.37；p<0.001)。修正ACL重建率平均为5.80%,保守治疗后ACL重建延迟率为18.51%。
■目前，没有足够的经验证据支持任何撕裂ACL的患者进行系统的手术重建.这篇综述发现保守治疗和手术治疗之间的功能结果没有差异。关于膝关节稳定性和二次半月板手术，结果更喜欢手术治疗。翻修和ACL重建延迟的发生率是不可忽视的因素，在选择合适的治疗方法之前，必须由外科医生和患者充分了解。
■此分析旨在比较功能，膝关节稳定性,ACL断裂患者保守治疗和手术治疗之间的二次手术发生率。
■通过Embase进行了系统搜索，OvidMedline,PubMed,科克伦图书馆,WebofScience,和谷歌学者报告ACL破裂后保守和手术治疗的结果。结果包括患者报告的结果测量(PROMs)，膝关节稳定性,需要二次半月板手术，延迟ACL重建手术，和修正ACL重建手术。使用平均差异或奇数比(OR)和95%CI分析结果。
■11项研究纳入1516例患者。对于PROM，我们的证据表明KOOS疼痛没有差异，KOOS症状,KOOSSport/Rec,KOOSADL,和KOOSQOL。(均p>0.05)。为了膝盖的稳定性，枢轴移位(或,0.14；p<0.001)，拉赫曼测试(或，0.06;p<0.001)，和胫骨平移(p<0.001)进行了评估，现有证据支持手术治疗而不是保守治疗。对于首次诊断后任何二次手术的发生率，手术组半月板手术率较低，具有统计学意义(OR，0.37；p<0.001)。修正ACL重建率平均为5.80%,保守治疗后ACL重建延迟率为18.51%。
■目前，没有足够的经验证据支持任何撕裂ACL的患者进行系统的手术重建.这篇综述发现保守治疗和手术治疗之间的功能结果没有差异。关于膝关节稳定性和二次半月板手术，结果更喜欢手术治疗。翻修和ACL重建延迟的发生率是不可忽视的因素，在选择合适的治疗方法之前，必须由外科医生和患者充分了解。
