| 标题： | 人工韧带重建特殊人群膝关节交叉韧带损伤的中国专家共识 |
| title： | Chinese expert consensus on artificial ligaments in knee cruciate ligament reconstruction in special populations |
| 版本： | 原创版 |
| version： | Original |
| 分类： | 专家共识 |
| classification： | Experts consensus |
| 领域： | 治疗 |
| field： | Treatment |
| 国家和地区： | 中国 |
| Country and region： | China |
| 指南使用者： | 运动医学医师、骨科医师、放射科医师、康复医师、治疗师、护士等专业医务人员 |
| Guide users： | Sports medicine surgeons, orthopedic surgeons, radiologist, rehabilitation physicians, therapists, nurses, etc. |
| 证据分级方法： | 无 |
| Evidence grading method： | none |
| 制定单位： | 中华医学会运动医疗分会下肢运动创伤学组 中国医师协会运动医学医师分会 |
| Formulating unit： | Lower Limb Sports Traumatology Group of Chinese Society of Sports Medicine; Sports Medicine Doctor Society of Chinese Medical Doctor Association |
| 注册时间： | 2023-12-17 |
| Registration time： | |
| 注册编号： | PREPARE-2023CN361 |
| Registration number： | |
| 指南制订的目的： | 膝关节交叉韧带损伤是最常见的运动损伤之一，常导致膝关节不稳、无力，远期易引起半月板损伤和膝关节骨关节炎的发生。国内外一致认为移植物重建是其标准治疗方式。自2004年国内开始使用以法国LARS为代表的新型人工韧带，因其无需获取和编织肌腱，具有手术方式简便、创伤更小的优势。特别是无需经历自体或异体移植物漫长重塑而长时间限制运动，适合于军事人员、运动员及高需求职业人员等需要尽快重返运动的特殊人群。鉴于人工韧带应用于该类特殊人群与普通患者存在明显差异，而国内外尚无权威的专家共识或指南。因此，为进一步规范该类特殊人群采用人工韧带重建膝关节交叉韧带损伤的治疗策略，在梳理该领域的最新证据基础上，中华医学会运动医疗分会下肢运动创伤学组和中国医师协会运动医学医师分会发起并制定《人工韧带重建特殊人群膝关节交叉韧带损伤的中国专家共识》。本共识针对特定手术人员选择、手术时机、术前准备、人工韧带移植物材料和设计特点、骨隧道定位及制作、人工韧带植入及张力测试和固定、特殊情况处理、术后康复方案及重返运动评估等提出建议，旨为规范人工韧带重建特殊人群膝关节交叉韧带损伤提供参考。 |
| Purpose of the guideline： | Knee cruciate ligament injury is one of the most prevalent sports injuries, often resulting in knee instability and weakness, and long-term susceptibility to meniscus injury and knee osteoarthritis. Graft reconstruction is widely acknowledged as the standard treatment both domestically and internationally. Since 2004, a novel type of artificial ligament, exemplified by French LARS, has been utilized in China due to its advantages of simplified surgery and reduced trauma as it eliminates the need for autograft tendon harvesting and fabricating. This approach is particularly suitable for military personnel, athletes, and high-demand professionals who require prompt return to sports activities without enduring prolonged rehabilitation associated with ligamentization of autologous or allogeneic grafts . However, there are discrepancies between applying artificial ligaments in this specific population versus ordinary patients; nevertheless, no consensus or guidelines exist nationally or globally. Therefore, to further standardize the treatment strategy of knee cruciate ligament injury reconstruction with artificial ligaments for this special population, the Lower Limb Sports Traumatology Group of Chinese Society of Sports Medicine and Sports Medicine Doctor Society of Chinese Medical Doctor Association initiated and formulated the 'Chinese expert consensus on artificial ligaments in knee cruciate ligament reconstruction in special populations', based on a comprehensive review of the latest evidence in the field. This consensus provides evidence-based recommendations for patient selection criteria, optimal surgical timing, preoperative preparations, material and design features of artificial ligament grafts, techniques for bone tunnel positioning and creation, procedures for artificial ligament implantation and tension testing, management of unique cases, postoperative rehabilitation programs, and return-to-sport assessments to establish standardized utilization of artificial ligament reconstruction for ACL injuries within these special populations. |
