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首页> 外文期刊>BMJ: British medical journal >Authors' response to editorial on treating ACL injuries
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Authors' response to editorial on treating ACL injuries

机译:作者对编辑把ACL受伤

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Levy and colleagues misinterpreted our report on the five year outcome of treatment for rupture of the anterior cruciate ligament (ACL). We assessed whether structured rehabilitation plus early ACL reconstructive surgery was superiorto structured rehabilitation with optional delayed reconstruction. We found no significant differences in primary or secondary outcomes between the two treatment strategies at five years. Knee stability was better in patients with surgical reconstruction but this did not translate into functional success. The median preinjury activity level of 9/10 indicated participation in competitive sports. Some 40% were active at their preinjury level at two years after injury, decreasing to 20% at five years, with no difference between groups. Our results are consistent with a meta-analysis showing that 22-61% return to competitive sports. Levy and colleagues incorrectly stated that "significantly more meniscal procedures were performed in the optional delayed group." We reported that at two years: "Subjects assigned to rehabilitation plus early ACL reconstruction had a higher frequency of meniscal surgery atstudyinitiationandalowerfrequency of delayed meniscal surgery than did subjects assigned to rehabilitation plus optional delayed ACL reconstruction. Overall, the number of meniscal operations in the two groups totalled 40 and 50, respectively (P=0.20)." After five years, we again found no significant differences in meniscus surgery when analysed by intention to treat or as treated. At five years after ACL rupture, we found no significant differences in radiographic osteoarthritis between the treatment groups. The practice of evidence based orthopaedics means integrating individual clinical expertise with the best available external clinical evidence from systematic research. The KANON trial currently represents the highest level clinical evidence.
机译:利维和同事误解我们的报告五年破裂的治疗结果前交叉韧带(ACL)。是否结构化康复+早期的ACL整形手术是superiorto结构化康复与可选的延迟重建。主要或次要的差异的结果两国在五个治疗策略年。但这没有手术重建成功转化为功能。受伤前的活动水平的9/10参与竞技体育。在两年活跃在受伤前的水平吗受伤后,减少20%,五年,组没有区别。符合一个荟萃分析显示22 - 61%回到竞技体育。同事们错误地声称“显著更多的半月板程序进行可选的延迟。”年:“科目分配到康复+早期的ACL重建有更高的频率半月板手术atstudyinitiationandalowerfrequency的延迟半月板手术比科目分配康复+可选推迟ACL重建。在两组总计40 - 50,分别(P = 0.20)。”再没有发现显著差异半月板手术分析意图的时候出现治疗或治疗。破裂,我们没有发现显著差异放射治疗之间的骨关节炎组。整形外科手段整合个人临床专业知识提供最好的从系统外部临床证据研究。临床证据的最高水平。

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