背景:

对于前交叉韧带(ACL)损伤手术和非手术治疗后1年和2年的成功结果，目前尚无金标准。这限制了研究人员和临床医生比较和对比干预措施结果的能力。

目的:

在专家共识的基础上建立一个共识，以确定ACL损伤或重建后1年和2年的成功结果。

方法:

通过电子邮件向国际运动医学协会的成员，包括美国运动医学骨科学会、欧洲运动创伤学、外科和膝关节镜学会以及美国物理治疗协会发送了一份调查。用频率计数分析盲法反应的趋势。计算了总和重要性百分比(SIP)， 80%的SIP在操作上表示共识。

结果:

共获得1779条响应。在手术和非手术治疗的六项措施上达成了共识:没有让步（不稳）、患者恢复运动、股四头肌和腘绳肌力量大于未受累肢体的90%、患者不超过轻度膝关节积液以及使用患者报告的结果(PRO)。没有单一的PRO达成共识，但建立了关于患者表现的PRO的阈值评分在85到90之间。

结论:

共识确定了ACL损伤或重建后成功预后的六个重要措施。它们代表了国际功能分类的所有级别:积液、让位、肌肉力量(身体结构和功能)、PRO(活动和参与)和重返运动(参与)，应包括在内，以便在干预措施之间进行比较。

Abstract

Background: No gold standard exists for identifying successful outcomes 1 and 2 years after operative and non-operative management of anterior cruciate ligament (ACL) injury. This limits the ability of a researcher and clinicians to compare and contrast the results of interventions.

Purpose: To establish a consensus based on expert consensus of measures that define successful outcomes 1 and 2 years after ACL injury or reconstruction.

Methods: Members of international sports medicine associations, including the American Orthopaedic Society for Sports Medicine, the European Society for Sports Traumatology, Surgery, and Knee Arthroscopy and the American Physical Therapy Association, were sent a survey via email. Blinded responses were analysed for trends with frequency counts. A summed importance percentage (SIP) was calculated and 80% SIP operationally indicated consensus.

Results: 1779 responses were obtained. Consensus was achieved for six measures in operative and non-operative management: the absence of giving way, patient return to sports, quadriceps and hamstrings' strength greater than 90% of the uninvolved limb, the patient having not more than a mild knee joint effusion and using patient-reported outcomes (PRO). No single PRO achieved consensus, but threshold scores between 85 and 90 were established for PROs concerning patient performance.

Conclusions: The consensus identified six measures important for successful outcome after ACL injury or reconstruction. These represent all levels of the International Classification of Functioning: effusion, giving way, muscle strength (body structure and function), PRO (activity and participation) and return to sport (participation), and should be included to allow for comparison between interventions.

From:

Br J Sports Med. 2015 Mar;49(5):335-42.

doi: 10.1136/bjsports-2013-092299. 

Epub 2013 Jul 23.