Higuchi Hiroshi, Terauchi Masanori, Kimura Masashi, Kobayashi Atsushi, Takeda Mitsuhiro, Watanabe Hideomi, Takagishi Kenji
Department of Orthopaedic Surgery, Gunma University Faculty of Medicine, 3-39-22 Showa-machi, Maebashi-shi, Gunma-ken 371-8511, Japan.
Acta Orthop Belg. 2003 Jun;69(3):257-66.
The purpose of this prospective study was to quantify and compare the amount of anterior tibial translation (ATT) occurring in ACL-reconstructed knees during both a static passive Lachman test and an isokinetic knee extension exercise, pre- and postoperatively. Stress-radiography combined with an electrogoniometer system was applied to 49 knees before and after ACL reconstruction. The Lysholm score was calculated and subjective evaluation assessed before operation and at follow-up. Both measurement methods confirmed a significant decrease of ATT after surgery. Side-to-side differences in ATT were seen in the passive Lachman test postoperatively, and were not found during isokinetic extension from 90 degrees to 0 degree. There was no significant correlation between static passive stability and the functional knee score at follow-up. In addition, the patients with a more than 3 mm side-to-side difference in the passive Lachman test after surgery, showed less than a 1 mm side-to-side difference during isokinetic exercise at a flexion angle of 20 degrees. These results suggest that ACL reconstruction improves ATT in both tests, but the side-to-side difference is greater with the static Lachman test.
这项前瞻性研究的目的是量化并比较前交叉韧带(ACL)重建术后膝关节在静态被动拉赫曼试验和等速膝关节伸展运动中,术前和术后胫前平移(ATT)的量。在49例ACL重建术前后的膝关节上应用应力放射摄影结合电子测角仪系统。计算Lysholm评分,并在术前和随访时进行主观评估。两种测量方法均证实术后ATT显著降低。术后被动拉赫曼试验中可见ATT的双侧差异,而在90度至0度等速伸展过程中未发现。随访时静态被动稳定性与膝关节功能评分之间无显著相关性。此外,术后被动拉赫曼试验中双侧差异超过3 mm的患者,在20度屈曲角度的等速运动中双侧差异小于1 mm。这些结果表明,ACL重建在两种试验中均能改善ATT,但静态拉赫曼试验的双侧差异更大。