Return to Play After Knee Articular Cartilage Restoration: Surgical Options, Rehabilitation Protocols, and Performance Outcomes.

IF 2.9 2区 医学 Q1 ORTHOPEDICS Current Reviews in Musculoskeletal Medicine Pub Date : 2023-12-01 Epub Date: 2023-10-07 DOI:10.1007/s12178-023-09872-w
Jairo Triana, Zachary I Li, Naina Rao, Matthew T Kingery, Eric J Strauss
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Abstract

Purpose of review: Numerous cartilage restoration techniques have proven to be effective in the treatment of articular cartilage defects. The ultimate goal of these procedures is to improve pain and function, thereby increasing the likelihood of a patient's return to physical activity. Postoperative rehabilitation is a key component for a successful and expedient return to activities. The purpose of this article is to review the current literature regarding common surgical options, rehabilitation protocols, and performance outcomes after operative treatment of articular cartilage defects.

Recent findings: Studies have demonstrated improved short- to long-term outcomes in a majority of techniques. However, the clinical benefits of microfracture are short-lived, which has led to the use of alternative procedures. Rehabilitation protocols are not standardized, but emphasis has been placed on bracing, weightbearing, early continuous passive range of motion, and strengthening to improve function. There is growing evidence to suggest that accelerated rehabilitation after matrix-induced autologous chondrocyte implantation may result in superior outcomes compared to delayed rehabilitation. Overall, most techniques result in satisfactory rates of return to play, though existing comparative studies typically include patients with heterogeneous pathology, complicating effective synthesis of outcomes data. In appropriately selected patients, cartilage restoration procedures after articular cartilage injury result in favorable patient-reported clinical outcomes and high rates of return to play. While studies emphasize the critical role that rehabilitation plays with respect to outcomes after surgery, there are substantial inconsistencies in protocols across techniques.

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膝关节软骨修复后重返赛场:手术选择、康复方案和表现结果。
综述目的:许多软骨修复技术已被证明在治疗关节软骨缺损方面是有效的。这些手术的最终目标是改善疼痛和功能,从而增加患者恢复体力活动的可能性。术后康复是成功和方便地恢复活动的关键组成部分。本文的目的是回顾目前关于关节软骨缺损手术治疗后常见手术选择、康复方案和表现结果的文献。最近的发现:研究表明,在大多数技术中,短期到长期的结果都有所改善。然而,微骨折的临床益处是短暂的,这导致了替代手术的使用。康复方案尚未标准化,但重点放在支撑、负重、早期持续被动活动范围和加强以改善功能上。越来越多的证据表明,与延迟康复相比,基质诱导的自体软骨细胞植入后加速康复可能会带来更好的结果。总的来说,尽管现有的比较研究通常包括具有异质性病理的患者,使结果数据的有效综合变得复杂,但大多数技术都能获得令人满意的恢复率。在适当选择的患者中,关节软骨损伤后的软骨修复程序可产生良好的患者报告的临床结果和高的恢复率。虽然研究强调了康复对手术后结果的关键作用,但不同技术的方案存在很大的不一致性。
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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