■使用快速康复方案在复发性髌骨脱位(RPD)后的术后恢复逐渐受到关注;尽管如此,缺乏其安全性和有效性的证据。
■比较RPD患者早期快速康复和保守康复的短期术后结局。
■随机对照试验;证据水平,2.
■共纳入2018年1月至2019年2月行胫骨结节截骨联合内侧髌股韧带重建的RPD患者50例。术后,将患者随机分为早期快速组(快速组;n=25例患者)或保守组(对照组;n=25例患者)进行康复训练.快速组在负重和运动范围(ROM)训练方面的进展较快。膝关节功能评分,ROM,双侧大腿围差异,和影像学数据在术前和术后6周以及术后3,6,12和24个月进行记录以进行比较.在24个月的随访期间记录术后并发症。
■两组之间的基线数据没有显着差异。术后,与对照组相比,快速组在6周和3个月时Tegner得分较高;在3和6个月时Lysholm得分较高;在6周时国际膝关节文献委员会得分较高,3个月,和12个月;更好的ROM;和更小的双侧大腿围差异在24个月(P<0.05)。然而,在Tegner中没有观察到差异,Lysholm,和国际膝关节文献委员会在术后24个月的评分。在为期6周和随后的随访中,对照组的Caton和Insall指数低于快速组(P<0.01)。此外,与对照组相比,快速组在24个月时髌骨baja的发生率较低(0%vs17%),在整个随访期间并发症较少(P<.01).
■对于接受胫骨结节截骨术联合内侧髌股韧带重建治疗RPD的患者,早期快速术后康复似乎是安全有效的。在短期内,这种方法在改善功能评分方面比保守康复更有利,允许更早恢复日常活动,尽管在24个月时没有差异意味着没有长期益处。此外,它可能有助于防止并发症的发生,包括baja髌骨.
■ChiCTR1800014648(ClinicalTrials.gov标识符)。
UNASSIGNED: Use of a rapid rehabilitation protocol for postoperative recovery after recurrent patellar dislocation (RPD) has gradually gained attention; nonetheless, evidence of its safety and effectiveness is lacking.
UNASSIGNED: To compare the short-term postoperative outcomes of early rapid rehabilitation with those of conservative rehabilitation in patients with RPD.
UNASSIGNED: Randomized controlled trial; Level of evidence, 2.
UNASSIGNED: A total of 50 patients with RPD who underwent tibial tubercle osteotomy combined with medial patellofemoral ligament reconstruction were enrolled between January 2018 and February 2019. Postoperatively, the patients were randomly assigned to either the early rapid group (rapid group; n = 25 patients) or the conservative group (control group; n = 25 patients) for rehabilitation training. The rapid group underwent faster progression in weightbearing and range of motion (ROM) training. Knee joint functional scores, ROM, bilateral thigh circumference differences, and imaging data were recorded preoperatively and at 6 weeks and 3, 6, 12, and 24 months postoperatively for comparison. Postoperative complications were recorded over the 24-month follow-up period.
UNASSIGNED: The baseline data did not significantly differ between the 2 groups. Postoperatively, compared with the control group, the rapid group had higher Tegner scores at 6 weeks and 3 months; higher Lysholm scores at 3 and 6 months; higher International Knee Documentation Committee scores at 6 weeks, 3 months, and 12 months; better ROM; and smaller bilateral thigh circumference differences at 24 months (P < .05 for all). However, no differences were observed in the Tegner, Lysholm, and International Knee Documentation Committee scores at 24 months postoperatively. At the 6-week and subsequent follow-up visits, the Caton and Insall indices were lower in the control group than in the rapid group (P < .01 for all). Moreover, compared with the control group, the rapid group had a lower incidence of patella baja at 24 months (0% vs 17%) and fewer complications during the whole follow-up period (P < .01).
UNASSIGNED: Early rapid postoperative rehabilitation appears to be safe and effective for patients who undergo tibial tubercle osteotomy combined with medial patellofemoral ligament reconstruction to treat RPD. In the short term, this approach was shown to be more advantageous than conservative rehabilitation in improving functional scores, allowing an earlier return to daily activities, although the lack of difference at 24 months implies no long-term benefits. In addition, it potentially helped to prevent the occurrence of complications, including patella baja.
UNASSIGNED: ChiCTR1800014648 (ClinicalTrials.gov identifier).