ACL重建术后加速康复与常规康复功能结果的对比分析
简介
44例初次ACL重建患者随机分为加速康复组与传统康复组，比较术后6周、3个月及9个月的Lysholm、IKDC评分、疼痛、关节活动度及稳定性。加速康复组在疼痛、关节活动度和患者报告功能上早期恢复更快，但差异无统计学意义，且未损害移植物稳定性，9个月时两组功能结果相当。提示在充分监督下，加速康复是ACL重建术后安全可行的康复选择。
英文摘要
INTRODUCTION: Post-operative rehabilitation is crucial for recovery following anterior cruciate ligament (ACL) reconstruction. While accelerated protocols aim to restore knee function more quickly, there are ongoing concerns about their impact on graft stability and long-term outcomes. This study examines the differences in functional outcomes between accelerated and traditional rehabilitation methods after primary ACL reconstruction. MATERIALS AND METHODS: A prospective randomized study on 44 patients undergoing primary arthroscopic ACL reconstruction was conducted. Patients were divided into two groups: conventional (n = 22) and accelerated rehabilitation (n = 22). Outcomes were measured preoperatively and at 6 weeks, 3 months, and 9 months using the Lysholm Knee Score, International Knee Documentation Committee (IKDC) score, visual analog scale for pain, knee range of motion (ROM), thigh circumference difference, and stability tests (Lachman, Anterior Drawer, and Pivot Shift). RESULTS: Both rehabilitation protocols led to significant improvements in Lysholm and IKDC scores, pain levels, knee ROM, quadriceps muscle recovery, and overall clinical stability during the follow-up. The accelerated rehab group tended to recover pain, knee ROM, and patient-reported function earlier in the post-operative period, but these differences were not statistically significant. Clinical stability was consistent across both groups throughout the follow-up, with no indication that the accelerated approach compromised graft stability. By 9 months, both protocols resulted in similar functional outcomes. CONCLUSION: Accelerated rehabilitation after ACL reconstruction yields functional outcomes comparable to those of conventional rehabilitation without compromising knee stability. While both protocols show positive early recovery trends, they lead to comparable medium-term results. Therefore, when adequately supervised, accelerated rehab is a safe option.