ACL重建术后早期康复的证据总结
简介
该文按6S证据模型系统检索指南、系统评价、专家共识及RCT等，纳入18篇文献，基于COM-B模型提炼出ACL重建术后早期（含术前）康复的27条最佳证据，覆盖评估、心理干预、疼痛肿胀管理、关节活动度、肌力恢复、支具与步态训练及随访。作者提示康复方案需按移植物类型、合并手术、基线活动水平和术后并发症个体化，其临床疗效与安全性仍待验证。
英文摘要
OBJECTIVE: To retrieve, evaluate, and summarize the best evidence for early-stage (and pre-operative) rehabilitation in patients with anterior cruciate ligament reconstruction, thereby providing an evidence-based foundation for the future development of early rehabilitation protocols. METHODS: Based on the "6S" evidence-based model, we systematically searched domestic and international guideline websites, websites of relevant professional societies and Chinese and international databases. Sources included clinical decisions, guidelines, systematic reviews, evidence summaries, expert consensuses, and randomized controlled trials. The search covered all records from the time of establishment to January 2026. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence. RESULTS: A total of 18 studies were included, consisting of 2 clinical decisions, 3 guidelines, 3 systematic reviews, 3 expert consensuses, 2 evidence summaries, and 5 randomized controlled trials. Based on the Capability, Opportunity, Motivation-Behaviour (COM-B) model, we extracted evidence and summarized a total of 27 best-evidence items across the following eight aspects: definition and goals, assessment, psychological intervention, pain and swelling management, range of motion recovery, restoring muscle function, brace use and gait training, and follow-up. CONCLUSION: This study summarized the best evidence for early-stage rehabilitation in ACLR patients, providing preliminary guidance for practice. Implementation requires individualization based on graft type, concomitant procedures, baseline activity level, and postoperative complications; moreover, its clinical efficacy and safety warrant further validation.