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前交叉韧带重建术后静态与动态膝关节稳定性之间的关系。

The relation between static and dynamic knee stability after ACL reconstruction.

作者信息

Higuchi Hiroshi, Terauchi Masanori, Kimura Masashi, Kobayashi Atsushi, Takeda Mitsuhiro, Watanabe Hideomi, Takagishi Kenji

机构信息

Department of Orthopaedic Surgery, Gunma University Faculty of Medicine, 3-39-22 Showa-machi, Maebashi-shi, Gunma-ken 371-8511, Japan.

出版信息

Acta Orthop Belg. 2003 Jun;69(3):257-66.

Abstract

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.

摘要

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。

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