左右膝关节松弛度测量：对前交叉韧带损伤患者和正常对照受试者的前瞻性研究。
Right and left knee laxity measurements: a prospective study of patients with anterior cruciate ligament injuries and normal control subjects.
作者信息
Sernert Ninni, Kartus Jüri T, Ejerhed Lars, Karlsson Jón
机构信息
Department of Orthopaedics, Norra Alvsborg/Uddevalla Hospital, the Fyrbodal Research Institute, Uddevalla, Sweden.
出版信息
Arthroscopy. 2004 Jul;20(6):564-71. doi: 10.1016/j.arthro.2004.04.056.
PURPOSE
The purpose of this study was to analyze and compare knee laxity in a group of patients with a unilateral right anterior cruciate ligament (ACL) rupture and a group of patients with a unilateral left ACL rupture. Another goal was to analyze and compare the knee laxity of the right and left knees in a group of persons without any known knee problems.
TYPE OF STUDY
Prospective examination of the same patients preoperatively and 2 years after the reconstruction with examination of the healthy controls at 2 different occasions.
METHODS
Group A was composed of 41 patients with a right-sided chronic ACL rupture, and group B was composed of 44 patients with a left-sided chronic ACL rupture. All patients underwent an arthroscopic ACL reconstruction using patellar tendon autograft. Group C was composed of 35 persons without any known knee problems. One experienced physiotherapist performed all the KT-1000 measurements and the clinical examinations.
RESULTS
Group A displayed an increased difference in side-to-side laxity between the injured and non-injured side compared with group B in terms of both anterior and total knee laxity. This difference was found to be statistically significant preoperatively (P =.01, anterior; P =.001, total) and at follow-up evaluation 2 years after the index surgery (P =.008, anterior; P =.006, total). In group C, a significant increase was seen in absolute anterior and total laxity in the right knee compared with the left knee when 2 repeated measurements were performed (P <.0001 and P =.003, anterior; P <.0001 and P =.001, total).
CONCLUSIONS
The KT-1000 arthrometer revealed a significant increase in laxity measurements in right knees compared with left knees. This difference was found both preoperatively and postoperatively in patients undergoing ACL reconstruction. The same thing was found in a group of persons without any known knee problems.
LEVEL OF EVIDENCE
Level II.
目的
本研究的目的是分析和比较一组单侧右前交叉韧带（ACL）断裂患者与一组单侧左ACL断裂患者的膝关节松弛度。另一个目标是分析和比较一组无任何已知膝关节问题的人群左右膝关节的松弛度。
研究类型
对同一组患者术前及重建术后2年进行前瞻性检查，并在2个不同时间点对健康对照者进行检查。
方法
A组由41例右侧慢性ACL断裂患者组成，B组由44例左侧慢性ACL断裂患者组成。所有患者均采用髌腱自体移植进行关节镜下ACL重建。C组由35例无任何已知膝关节问题的人组成。一名经验丰富的物理治疗师进行所有KT-1000测量和临床检查。
结果
就前向和全膝关节松弛度而言，A组受伤侧与未受伤侧的侧方松弛度差异较B组增大。术前（前向：P = 0.01；全膝关节：P = 0.001）及首次手术后2年的随访评估中（前向：P = 0.008；全膝关节：P = 0.006），该差异具有统计学意义。在C组中，当进行2次重复测量时，右膝关节的绝对前向和全膝关节松弛度较左膝关节显著增加（前向：P < 0.0001，P = 0.003；全膝关节：P < 0.0001，P = 0.001）。
结论
KT-1000关节测量仪显示，右膝关节的松弛度测量值较左膝关节显著增加。这一差异在接受ACL重建的患者术前和术后均被发现。在一组无任何已知膝关节问题的人群中也发现了同样的情况。
证据级别
二级。
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