前交叉韧带重建术后营养与康复：一项系统综述
简介
本系统综述纳入15项研究（2项观察性饮食研究、13项随机对照试验），评估营养对前交叉韧带重建（ACLR）术后康复及重返运动的影响。关键发现：高蛋白摄入与腘绳肌腱或骨-髌腱-骨移植物患者术后肌肉质量保留及功能恢复改善相关；亚麻籽油（omega-3脂肪酸）和亮氨酸补充显示一定潜力；纠正维生素D不足可能有益。但多数研究存在严重偏倚风险，且仅1项研究涉及重返运动结局…
英文摘要
PURPOSE: As the impact of nutrition on rehabilitation and return to sport (RTS) after ACL reconstruction (ACLR) remains largely unexplored, this review aimed to review the current evidence on the role of nutrition in rehabilitation outcomes for ACLR patients, with as ultimate goal a safer and more successful RTS. METHODS: Systematic review, adhering to PRISMA. Studies were selected from PubMed, EMBASE, and Web of Science with as mean search strings 'ACL*' and 'Nutrition', and/or 'Diet*'. A broad approach was applied considering populations/patients of any age undergoing ACLR, with nutritional focus, including randomised and non-randomised trials, as well as observational studies. Data were extracted and analysed; risk of bias assessments by RoB 2 and ROBINS-I tools RESULTS: Fifteen studies were included. Two observational studies examined the effects of diet exposure, while 13 RCTs considered specific supplements, alongside any form of physical therapy. RTS was only considered in a single trial only. Serious risk of bias and critical issue were identified in the majority of the studies. This risk of bias and the variability across studies meant that there was not enough high-quality data to perform meta-analyses. Protein intake was associated with improved muscle mass retention and functional recovery. Flaxseed oil (omega 3 fatty acids) and leucine showed some promise. For vitamin-D, correcting insufficiency seemed warranted. CONCLUSION: A high protein intake along with physical rehabilitation is related to improved muscle mass and function, however the impact on RTS and other ACLR outcomes needs to be established. Supplements like leucine and flaxseed oil, and correcting vitamin D inadequacy deserve more attention. More high-quality research is needed to formulate specific personalised nutritional guidelines for ACLR rehabilitation. LEVEL OF EVIDENCE: Level NA.