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前交叉韧带损伤患者的临床与膝关节动态功能比较

Comparison of clinical and dynamic knee function in patients with anterior cruciate ligament deficiency.

作者信息

Patel Rohita R, Hurwitz Debra E, Bush-Joseph Charles A, Bach Bernard R, Andriacchi Thomas P

机构信息

Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois 60612, USA.

出版信息

Am J Sports Med. 2003 Jan-Feb;31(1):68-74. doi: 10.1177/03635465030310012301.

Abstract

BACKGROUND

Whether passive measures of isokinetic muscle strength deficits and knee laxity are related to the dynamic function of the anterior cruciate ligament-deficient knee remains unclear.

HYPOTHESES

Arthrometer measurements are not predictive of peak external knee flexion moment (net quadriceps muscle moment), isokinetic quadriceps muscle strength correlates with peak external knee flexion moment (net quadriceps muscle moment), and isokinetic hamstring muscle strength correlates with peak external knee extension moment (net flexor muscle moment).

STUDY DESIGN

Cross-sectional study.

METHODS

Gait analysis was used to assess dynamic function during walking, jogging, and stair climbing in 44 subjects with unilateral anterior cruciate ligament deficiency and 44 control subjects. Passive knee laxity and isokinetic quadriceps and hamstring muscle strength were also measured.

RESULTS

Arthrometer measurements did not correlate with peak external flexion or extension moments in any of the activities tested or with isokinetic quadriceps or hamstring muscle strength. Test subjects also had a significantly reduced peak external flexion moment during all three jogging activities and stair climbing compared with the control subjects and this was correlated with significantly reduced quadriceps muscle strength.

CONCLUSIONS

Absolute knee laxity difference did not correlate with dynamic knee function as assessed by gait analysis and should not be used as a sole predictor for the outcome of treatment. Patients with greater than normal strength in the anterior cruciate ligament-deficient limb performed low- and high-stress activities in a more normal fashion than those with normal or less-than-normal strength.

摘要

背景

等速肌力 deficits 和膝关节松弛度的被动测量指标与前交叉韧带损伤膝关节的动态功能之间是否相关尚不清楚。

假设

关节测量仪测量结果不能预测膝关节最大外展屈曲力矩(股四头肌净力矩),等速股四头肌肌力与膝关节最大外展屈曲力矩(股四头肌净力矩)相关,等速腘绳肌肌力与膝关节最大伸展力矩(屈肌净力矩)相关。

研究设计

横断面研究。

方法

采用步态分析评估 44 名单侧前交叉韧带损伤患者和 44 名对照者在行走、慢跑和爬楼梯过程中的动态功能。同时测量膝关节被动松弛度以及等速股四头肌和腘绳肌肌力。

结果

在任何测试活动中,关节测量仪测量结果均与最大外展屈曲或伸展力矩以及等速股四头肌或腘绳肌肌力无关。与对照者相比,测试对象在所有三种慢跑活动和爬楼梯过程中的最大外展屈曲力矩也显著降低,这与股四头肌肌力显著降低相关。

结论

通过步态分析评估,绝对膝关节松弛度差异与膝关节动态功能无关,不应作为治疗结果的唯一预测指标。前交叉韧带损伤肢体力量大于正常的患者在进行低应力和高应力活动时比力量正常或低于正常的患者表现得更正常。

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