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I never made it to the pros… Return to sport and becoming an elite athlete after pediatric and adolescent anterior cruciate ligament injury—Current evidence and future directions

机译:我从来都没有成为职业选手……小儿和青少年前十字韧带损伤后重返体育界并成为一名优秀运动员—当前证据和未来方向

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摘要

The management of anterior cruciate ligament (ACL) injuries in the skeletally immature and adolescent patient remains an area of controversy in sports medicine. This study, therefore, summarizes and discusses the current evidence related to treating pediatric and adolescent patients who sustain an ACL injury. The current literature identifies a trend towards ACL reconstruction as the preferred treatment option for ACL injuries in the young, largely justified by the risk of further structural damage to the knee joint. Worryingly, a second ACL injury is all too common in the younger population, where almost one in every three to four young patients who sustain an ACL injury and return to high-risk pivoting sport will go on to sustain another ACL injury. The clinical experience of these patients emphasizes the rarity of an athlete who makes it to elite level after a pediatric or adolescent ACL injury, with or without reconstruction. If these patients are unable to make it to an elite level of sport, treatment should possibly be modified to take account of the risks associated with returning to pivoting and strenuous sport. The surveillance of young athletes may be beneficial when it comes to reducing injuries. Further research is crucial to better understand specific risk factors in the young and to establish independent structures to allow for unbiased decision-making for a safe return to sport after ACL injury. Level of evidence V.
机译:骨骼未成熟和青春期患者的前交叉韧带(ACL)损伤的管理仍然是运动医学领域中一个有争议的领域。因此,本研究总结并讨论了与治疗遭受ACL损伤的儿童和青少年患者有关的当前证据。目前的文献确定了将ACL重建作为年轻人ACL损伤的首选治疗方案的趋势,这在很大程度上受到膝关节进一步结构性损伤的风险的证明。令人担忧的是,第二例ACL损伤在年轻人群中太普遍了,在那里,每三到四名遭受ACL损伤并重返高危轮转运动的年轻患者中,将有近一例继续遭受另一例ACL损伤。这些患者的临床经验强调,在有或没有重建的小儿或青少年ACL损伤后,使运动员达到精英水平的运动员很少。如果这些患者无法将其提高到运动的水平,则应修改治疗方法,以考虑到重返极限运动和剧烈运动带来的风险。在减少伤害方面,对年轻运动员的监视可能是有益的。进一步的研究对于更好地了解年轻人的特定危险因素并建立独立的结构以使ACL受伤后能够安全地恢复运动而做出无偏见的决策至关重要。证据水平V.

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