膝关节部分外展机制撕裂的运动员在接受手术和非手术治疗后恢复运动的比率各不相同：系统回顾

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-08-01 DOI:10.1016/j.asmr.2024.100944

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引用次数: 0

摘要

目的(1)系统回顾专业和业余运动员部分伸肌肌腱撕裂的治疗方法；(2)报告接受手术治疗与非手术治疗的患者的疗效。只要是报道运动员膝关节部分伸肌机制撕裂的手术或非手术治疗结果的文章均被纳入。该综述符合《系统综述和荟萃分析首选报告项目》标准。每项研究都询问了人口统计学、受伤肌腱、运动员的运动项目和水平、之前的治疗方法、最终治疗方式以及治疗后恢复运动（RTS）的结果。结果十项研究符合纳入标准，共纳入 191 例髌骨或股四头肌腱部分撕裂。其中，81.6%的患者为男性，18.4%为女性，平均年龄为21至28岁；97%的患者接受了初步非手术治疗。最终，111 名患者（58.1%）接受了非手术治疗，80 名患者（41.9%）接受了手术治疗。在手术中，39 例（48.8%）为肌腱清创术，36 例（45.0%）为修复术，5 例（6.3%）不详。手术后的 RTS 发生率为 33% 至 93%，保守治疗后的 RTS 发生率为 70% 至 89%。在职业运动员中，23 人（33%）接受了手术，46 人（67%）接受了最终的保守治疗。结论几乎所有外展肌部分撕裂的患者都接受了最初的非手术治疗。结论几乎所有的外展肌部分撕裂患者都接受了最初的非手术治疗，RTS 发生率较高，但在接受最终非手术治疗和手术治疗的患者中，RTS 发生率存在一定差异。即使在职业运动员中，大多数损伤也是通过最初的非手术疗法治疗的，并没有发展到手术治疗。

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Athletes With Partial Extensor Mechanism Tears of the Knee Achieve Variable Return-to-Sport Rates Following Operative Versus Nonoperative Management: A Systematic Review

Purpose

(1) To systematically review treatments for partial extensor mechanism tendon tears in professional and amateur athletes and (2) to report outcomes for patients undergoing operative versus nonoperative management.

Methods

PubMed, Cochrane, Scopus, Google Scholar, and Web of Science were queried in August 2023 using the following Boolean search: (quadriceps OR patella) AND (partial) AND (tear). Articles were included if they reported outcomes of operative or nonoperative management of partial extensor mechanism tears of the knee in athletes. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria. Each study was queried for demographics, tendon injured, sport and level of athlete, prior treatments, final treatment modality, and return to sport (RTS) outcomes of that treatment. A qualitative subanalysis was performed for professional athletes.

Results

Ten studies met inclusion criteria and included 191 partial patellar or quadriceps tendon tears. Of the patients, 81.6% were male and 18.4% were female, with average age ranging from 21 to 28 years; 97% of patients underwent initial nonoperative management. Ultimately, 111 patients (58.1%) were maintained on nonoperative management, and 80 (41.9%) progressed to surgery. Of surgeries, 39 (48.8%) were tendon debridements, 36 (45.0%) were repairs, and 5 (6.3%) were not specified. RTS rates ranged from 33% to 93% after surgery and 70% to 89% following conservative management. Of professional athletes, 23 (33%) underwent surgery, and 46 (67%) underwent ultimate conservative management. RTS rates ranged from 33% to 67% after surgery and were 89% for the applicable study of conservative management.

Conclusions

Nearly all patients with partial extensor mechanism tears underwent initial nonoperative management. RTS rates were high but somewhat variable among both patients treated with final nonoperative versus surgical management. Even among professional athletes, most injuries were treated with initial nonoperative management and did not progress to surgery.