早期加速与延迟负重康复方案对膝关节前交叉韧带重建术后疗效的Meta分析

A Meta-Analysis of Effect of Early Accelerated vs Delayed Weight-Bearing Rehabilitation Programs after Anterior Cruciate Ligament Reconstruction

摘要: 目的：本研究采用Meta分析评价早期加速与延迟负重康复方案对膝关节前交叉韧带(ACL)重建术后临床疗效，为术后康复方案优化提供循证依据。方法：检索PubMed、Embase、MEDLINE、Web of Science和Cochrane Library数据库(建库至2025年8月)，纳入ACL术后成人患者采用延迟或加速负重康复方案的研究；提取IKDC、Lysholm、Tegner评分及膝关节松弛度等结局，并按Cochrane手册评价文献质量；采用R 4.0.5进行Meta分析。结果：共纳入14项研究。加速负重组IKDC评分更高；Lysholm、Tegner评分及膝关节松弛度与延迟负重组比较差异均无统计学意义。结论：在充分考虑个体差异及术后具体情况的前提下，早期加速负重康复有利于膝关节功能恢复，可作为更合适的选择之一。

Abstract: Objective: This meta-analysis compared early accelerated versus delayed weight-bearing rehabilitation after anterior cruciate ligament (ACL) reconstruction in adults to provide evidence-based guidance for postoperative care. Methods: We systematically searched PubMed, Embase, MEDLINE, Web of Science and the Cochrane Library from inception to August 2025 for randomized or quasi-randomized trials that assigned adult ACL-reconstruction patients to either an accelerated or a delayed weight-bearing protocol; data on IKDC, Lysholm and Tegner scores and knee laxity were extracted, study quality was appraised with the Cochrane risk-of-bias tool, and meta-analyses were performed in R 4.0.5. Results: Fourteen studies met the inclusion criteria. The accelerated group achieved significantly higher IKDC scores, whereas Lysholm, Tegner and laxity outcomes did not differ between groups. Conclusion: When individual patient factors and postoperative status are taken into account, early accelerated weight-bearing facilitates better knee function and can be considered a preferable rehabilitation option.