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首页> 外文期刊>The Journal of Bone and Joint Surgery. American Volume >Prevention and screening programs for anterior cruciate ligament injuries in young athletes: A cost-effectiveness analysis
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Prevention and screening programs for anterior cruciate ligament injuries in young athletes: A cost-effectiveness analysis

机译：青年运动员前交叉韧带损伤的预防和筛查程序：成本效益分析

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Background: Anterior cruciate ligament (ACL) injuries are common among young athletes. Biomechanical studies have led to the development of training programs to improve neuromuscular control and reduce ACL injury rates as well as screening tools to identify athletes at higher risk for ACL injury. The purpose of this study was to evaluate the costeffectiveness of these training methods and screening strategies for preventing ACL injuries. Methods: A decision-analysis model was created to evaluate three strategies for a population of young athletes participating in organized sports: (1) no training or screening, (2) universal neuromuscular training, and (3) universal screening, with neuromuscular training for identified high-risk athletes only. Risk of injury, risk reduction from training, and sensitivity and specificity of screening were based on published data from clinical trials. Costs of training and screening programswere estimated on the basis of the literature. Sensitivity analyses were performed on keymodel parameters to evaluate their effect on base case conclusions. Results: Universal neuromuscular training of all athletes was the dominant strategy, with better outcomes and lower costs compared with screening. On average, the implementation of a universal training program would save $100 per player per season, and would reduce the incidence of ACL injury from 3% to 1.1% per season. Screening was not costeffective within the range of reported sensitivity and specificity values. Conclusions and Clinical Relevance: Given its low cost and ease of implementation, neuromuscular training of all young athletes represents a cost-effective strategy for reducing costs and morbidity from ACL injuries.While continued innovations on inexpensive and accurate screening methods to identify high-risk athletes remain of interest, improving existing training protocols and implementing neuromuscular training into routine training for all young athletes is warranted.
机译：背景：前十字韧带（ACL）受伤在年轻运动员中很常见。生物力学研究已导致开发训练计划以改善神经肌肉控制并降低ACL损伤率，并建立了筛查工具以识别运动员中ACL损伤风险更高。这项研究的目的是评估这些培训方法和预防ACL损伤的筛查策略的成本效益。方法：建立决策分析模型，以评估针对参加有组织体育活动的年轻运动员群体的三种策略：（1）不进行训练或筛查;（2）普适性神经肌肉训练;以及（3）普适性筛查，其中进行神经肌肉训练仅确定高风险运动员。受伤的风险，培训的风险降低，筛查的敏感性和特异性均基于临床试验中已发表的数据。培训和筛查计划的成本是根据文献估算的。对关键模型参数进行了敏感性分析，以评估它们对基本案例结论的影响。结果：所有运动员的通用神经肌肉训练是主要策略，与筛查相比，结果更好，成本更低。平均而言，实施通用培训计划将为每名球员每个赛季节省100美元，并将ACL伤害的发生率从每个赛季的3％降低到1.1％。在报道的敏感性和特异性值范围内，筛查并非具有成本效益。结论与临床意义：鉴于其成本低廉且易于实施，对所有年轻运动员进行神经肌肉训练是降低ACL损伤的成本和发病率的一种经济有效的策略，同时继续在廉价，准确的筛查方法上进行创新以识别高风险运动员。仍然有兴趣的是，有必要改进现有的训练方案并将神经肌肉训练纳入所有年轻运动员的常规训练中。

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