Non-operative Management of Acute Knee Injuries.

IF 2.9 2区 医学 Q1 ORTHOPEDICS Current Reviews in Musculoskeletal Medicine Pub Date : 2024-01-01 Epub Date: 2023-12-14 DOI:10.1007/s12178-023-09875-7
Shaheen Jadidi, Aaron D Lee, Eliza J Pierko, Haemi Choi, Nathaniel S Jones
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Abstract

Purpose of review: Acute knee injuries are commonly encountered in both the clinical and sideline setting and may be treated operatively or non-operatively. This article describes an evidence-based approach to non-operative acute knee injury. This includes history, physical exam, imaging, and initial management. In addition, the non-operative management of three such injuries-ligament injury, meniscus injury, and patellar dislocation injury-will be discussed via a case-based practical approach.

Recent findings: Aside from grade III ACL tears, most acute knee ligament injuries, especially in the absence of other concurrent injuries, can be treated non-operatively. There is new evidence that acute traumatic meniscus tears in those younger than 40 can be successfully treated non-operatively and can do equally, as well as those that undergo surgery, at 1 year out from injury. Based on the current literature, a short period of knee bracing in extension with progression to weightbearing to tolerance is recommended after initial patellar dislocation. Many of the most common acute knee injuries, including MCL tears, meniscus tears, and patellar dislocations, can be managed non-operatively. A detailed systemic approach to initial evaluation, including pertinent history, physical exam, and appropriate imaging, is essential and complementary to the subsequent non-operative treatment algorithm.

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急性膝关节损伤的非手术治疗。
审查目的:急性膝关节损伤常见于临床和赛场,可通过手术或非手术治疗。本文介绍了非手术治疗急性膝关节损伤的循证方法。其中包括病史、体格检查、影像学检查和初步处理。此外,本文还将通过基于病例的实用方法讨论三种此类损伤的非手术治疗方法--韧带损伤、半月板损伤和髌骨脱位损伤:最近的研究结果:除了前交叉韧带 III 级撕裂外,大多数急性膝关节韧带损伤,尤其是在没有其他并发损伤的情况下,都可以采用非手术治疗。有新的证据表明,40 岁以下的急性外伤性半月板撕裂可以成功地进行非手术治疗,并且在受伤 1 年后的表现与接受手术治疗的患者相同。根据目前的文献,在初次髌骨脱位后,建议进行短时间的膝关节伸直支撑,然后逐渐负重至耐受。许多最常见的急性膝关节损伤,包括 MCL 撕裂、半月板撕裂和髌骨脱位,都可以通过非手术治疗。详细的系统性初步评估方法,包括相关病史、体格检查和适当的影像学检查,对于随后的非手术治疗算法至关重要,也是一种补充。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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