Timing of Surgery & Rehabilitation After Multiligamentous Knee Reconstruction.

IF 2.9 2区 医学 Q1 ORTHOPEDICS
Zachary J Herman, Janina Kaarre, Anja M Wackerle, Ariana Lott, Nicholas A Apseloff, Bryson P Lesniak, James J Irrgang, Volker Musahl
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Abstract

Purpose of review: To provide an overview of the current evidence of the timing of surgery and rehabilitation after multiligamentous knee injuries (MLKIs) and offer insights into the ongoing multi-center randomized controlled study, the 'STaR trial'.

Recent findings: Due to the complexity of the MKLIs, they are usually treated surgically with the goal of either repairing or reconstructing the injured ligaments. Although the current literature on MLKIs is relatively extensive, the consensus on the timing of surgery or rehabilitation following surgery for MLKIs is still lacking. While current literature mostly suggests early treatment, there is also evidence preferring delayed treatment. Furthermore, evidence on the timing of postoperative rehabilitation is limited. Thus, the current multi-center randomized controlled study, the 'STaR trial', is expected to respond to these questions by adding new high-level evidence. The MLKIs are often associated with knee dislocation and constitute a highly complex entity, including concomitant injuries, such as neurovascular, meniscal, and cartilaginous injuries. The treatment of MLKIs usually aims to either repair or reconstruct the injured ligaments, however, there is no general consensus on the timing of surgery or rehabilitation following an MLKI surgery. This current review stresses the need for more high-level research to address the paucity of evidence-based treatment guidelines for the treatment of complex MLKIs.

多韧带膝关节重建术后的手术和康复时机。
综述目的:概述膝关节多韧带损伤(MLKIs)后手术和康复时机的现有证据,并对正在进行的多中心随机对照研究 "STAR 试验 "提出见解:由于多韧带膝关节损伤的复杂性,通常采用手术治疗,目的是修复或重建受伤的韧带。尽管目前关于多发性韧带损伤的文献相对较多,但对于多发性韧带损伤的手术时机或术后康复仍缺乏共识。虽然目前的文献大多建议尽早治疗,但也有证据表明患者更倾向于延迟治疗。此外,关于术后康复时机的证据也很有限。因此,目前的多中心随机对照研究 "STAR 试验 "有望通过增加新的高水平证据来回答这些问题。MLKI通常与膝关节脱位有关,是一种非常复杂的疾病,包括神经血管、半月板和软骨损伤等并发症。治疗 MLKI 的目的通常是修复或重建受伤的韧带,但对于 MLKI 手术后的手术时机或康复治疗,目前尚无普遍共识。本综述强调有必要开展更高层次的研究,以解决治疗复杂韧带损伤缺乏循证治疗指南的问题。
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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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