Georgoulis A D, Ristanis S, Papadonikolakis A, Tsepis E, Moebius U, Moraiti C, Stergiou N
Orthopaedic Sports Medicine Center, Department of Orthopaedic Surgery, University of Ioannina, P. O. Box 1330, Ioannina 45110, Greece.
Knee Surg Sports Traumatol Arthrosc. 2005 Sep;13(6):437-43. doi: 10.1007/s00167-005-0656-3. Epub 2005 Jun 21.
Although the scar tissue, which heals the donor site defect, has different elasticity from the neighbouring patellar tissue, it remains unclear if this scar tissue can lead to the changes of the electromechanical delay (EMD) of the knee extensor muscles. If such changes do exist, they can possibly affect both the utilization of the stored energy in the series elastic component, as well as the optimal performance of the knee joint movement. The purpose of this study was to investigate the influence of harvesting the patellar tendon during anterior cruciate ligament (ACL) reconstruction and the associated patellar tendon scar tissue development on the EMD of the rectus femoris (RF) and vastus medialis (VM) muscles. Seventeen patients who underwent an ACL reconstruction using the medial third of the patellar tendon were divided in two groups based upon their post-operative time interval. Maximal voluntary contraction from the knee extensors, surface EMG activity, and ultrasonographic measurements of the patellar tendon cross-section area were obtained from both knees. Our results revealed that no significant changes for the maximal voluntary contraction of the knee extensors and for the EMD of the RF and the VM muscles due to patellar scar tissue development after harvesting the tendon for ACL reconstruction. The EMD, as a component of the stretch reflex, is important for the utilization of the stored energy in the series elastic component and thus, optimal sports performance. However, from our results, it can be implied that the ACL reconstruction using a patellar tendon graft would not impair sports performance as far as EMD is concerned.
尽管用于修复供区缺损的瘢痕组织与相邻的髌腱组织具有不同的弹性,但目前尚不清楚这种瘢痕组织是否会导致膝伸肌的机电延迟(EMD)发生变化。如果确实存在这种变化,它们可能会影响串联弹性成分中储存能量的利用,以及膝关节运动的最佳性能。本研究的目的是探讨在前交叉韧带(ACL)重建过程中取髌腱以及相关的髌腱瘢痕组织形成对股直肌(RF)和股内侧肌(VM)的EMD的影响。17例采用髌腱内侧三分之一进行ACL重建的患者根据术后时间间隔分为两组。从双膝获取膝伸肌的最大自主收缩、表面肌电图活动以及髌腱横截面积的超声测量结果。我们的结果显示,在为ACL重建取腱后,由于髌腱瘢痕组织形成,膝伸肌的最大自主收缩以及RF和VM肌肉的EMD均无显著变化。EMD作为牵张反射的一个组成部分,对于串联弹性成分中储存能量的利用以及最佳运动表现非常重要。然而,从我们的结果可以推断,就EMD而言,使用髌腱移植进行ACL重建不会损害运动表现。