前交叉韧带撕裂的非手术治疗：证据与适应证
简介
前交叉韧带（ACL）损伤常见于运动员与非运动员。美国每年报告约20万例损伤及10万例重建手术。尽管ACL重建是标准治疗，但对于经过筛选的患者，在结构化康复方案下，非手术治疗可获得相似的短期与长期疗效。此外，ACL重建存在再损伤、对侧损伤及术后骨关节炎等风险。早期康复（或称术前康复）可加速症状、肌力及膝关节功能的恢复，其双重目的为：判断患者是否为“适应者”（c…
英文摘要
Anterior cruciate ligament injuries commonly affect athletes and nonathletes. In the United States, about 200,000 injuries and 100,000 reconstructions are reported annually. While anterior cruciate ligament reconstruction is the standard treatment, nonsurgical options can yield similar short- and long-term results for selected patients with a structured rehabilitation program. Also, anterior cruciate ligament reconstruction has risks, including reinjury, contralateral injuries, and postoperative osteoarthritis. Early rehabilitation, or prehabilitation, accelerates recovery of symptoms, strength, and knee function. It serves two main purposes: identifying whether a patient is a coper and suitable for continued nonsurgical management or preparing them for surgery if needed. Nonsurgical treatment may be appropriate for selected patients. This review provides a practical guide to nonsurgical management, emphasizing the importance of patient selection, early individualized rehabilitation, and patient education to optimize outcomes.