Conservative Management and Postoperative Return to Sport in Endurance Athletes with Flow Limitations in the Iliac Arteries: A Scoping Review,Sports Medicine

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Conservative Management and Postoperative Return to Sport in Endurance Athletes with Flow Limitations in the Iliac Arteries: A Scoping Review
Sports Medicine ( IF 9.3 ) Pub Date : 2024-09-13 , DOI: 10.1007/s40279-024-02105-1
Jem I Arnold ₁ , Alishah Mawji ₂ , Kathryn Stene ₃ , David C Taylor ₄ , Michael S Koehle _{1,

5}

Affiliation

Background

Flow limitations in the iliac arteries (FLIA) is a sport-related vascular condition increasingly recognised as an occupational risk for professional cyclists and other endurance athletes. Surgical reconstruction is the definitive treatment for athletes wishing to continue competition. However, less information has been published regarding conservative management options and return-to-sport (RTS) guidelines.

Objective

Our aim was to review the existing literature on conservative treatment of FLIA, identify knowledge gaps and propose an RTS framework for athletes returning to competition.

Methods

A comprehensive literature review was performed using the Ovid-MEDLINE, PubMed, Embase and PEDro databases for publications relevant to conservative management of FLIA. A scoping review was conducted following PRISMA-ScR guidelines. Original, peer-reviewed publications in English describing conservative or postoperative management for athletes with FLIA were included. Additional grey literature and clinical expertise were consulted to inform RTS guidelines.

Results

Overall, 62 studies were included in this review. In total, 11 categories of conservative modalities were extracted and presented qualitatively in terms of the information source (discussion or results statements) and perspective of the authors (positive, negative or mixed). We have proposed RTS guidelines covering pre-operative preparation and postoperative rehabilitation based on the available literature, clinical experience, and drawing from other areas of sports medicine research.

Conclusion

There is insufficient literature evaluating the effectiveness of conservative management options for FLIA to establish best practices. Considering the importance of RTS for competitive athletes, we proposed practical guidelines to help with clinician and patient decision making. Future consensus should be sought for RTS best practices.

中文翻译：

髂动脉血流受限耐力运动员的保守治疗和术后恢复运动：范围综述

背景

髂动脉血流受限（FLIA）是一种与运动相关的血管疾病，越来越被认为是职业自行车手和其他耐力运动员的职业风险。手术重建是希望继续比赛的运动员的确定性治疗方法。然而，关于保守治疗方案和重返运动（RTS）指南的信息较少。

目的

我们的目标是回顾关于 FLIA 保守治疗的现有文献，确定知识差距并为重返赛场的运动员提出 RTS 框架。

方法

使用 Ovid-MEDLINE 、 PubMed 、 Embase 和 PEDro 数据库对与 FLIA 保守治疗相关的出版物进行了全面的文献综述。按照 PRISMA-ScR 指南进行了范围审查。包括描述 FLIA 运动员保守或术后管理的原始同行评审英文出版物。查阅了其他灰色文献和临床专业知识，为 RTS 指南提供信息。