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腘绳肌腱用于前交叉韧带重建后,膝关节屈肌的机电延迟会受损。

Electromechanical delay of the knee flexor muscles is impaired after harvesting hamstring tendons for anterior cruciate ligament reconstruction.

机构信息

Orthopaedic Sports Medicine Center of Ioannina, Department of Orthopaedic Surgery, University of Ioannina, Ioannina, Greece.

出版信息

Am J Sports Med. 2009 Nov;37(11):2179-86. doi: 10.1177/0363546509340771. Epub 2009 Aug 14.

Abstract

BACKGROUND

Changes in electromechanical delay during muscle activation are expected when there are substantial alterations in the structural properties of the musculotendinous tissue. In anterior cruciate ligament reconstruction, specific tendons are being harvested for grafts. Thus, there is an associated scar tissue development at the tendon that may affect the corresponding electromechanical delay.

PURPOSE

This study was conducted to investigate whether harvesting of semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction will affect the electromechanical delay of the knee flexors.

STUDY DESIGN

Case-control study; Level of evidence, 3.

METHODS

The authors evaluated 12 patients with anterior cruciate ligament reconstruction with a semitendinosus and gracilis autograft, 2 years after the reconstruction, and 12 healthy controls. Each participant performed 4 maximally explosive isometric contractions with a 1-minute break between contractions. The surface electromyographic activity of the biceps femoris and the semitendinosus was recorded from both legs during the contractions.

RESULTS

The statistical comparisons revealed significant increases of the electromechanical delay of the anterior cruciate ligament-reconstructed knee for both investigated muscles. Specifically, the electromechanical delay values were increased for both the biceps femoris (P = .029) and the semitendinosus (P = .005) of the reconstructed knee when compared with the intact knee. Comparing the anterior cruciate ligament-reconstructed knee against healthy controls revealed similar significant differences for both muscles (semitendinosus, P = .011; biceps femoris, P = .024).

CONCLUSION

The results showed that harvesting the semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction significantly increased the electromechanical delay of the knee flexors. Increased hamstring electromechanical delay might impair knee safety and performance by modifying the transfer time of muscle tension to the tibia and therefore affecting muscle response during sudden movements in athletic activities. However, further investigation is required to identify whether the increased electromechanical delay of the hamstrings can actually influence optimal sports performance and increase the risk for knee injury in athletes with anterior cruciate ligament reconstructions.

摘要

背景

当肌肉肌腱组织的结构特性发生重大改变时,肌肉激活过程中的机电延迟会发生变化。在前交叉韧带重建中,特定的肌腱被用于移植物。因此,在肌腱处会产生相关的疤痕组织,这可能会影响相应的机电延迟。

目的

本研究旨在探讨前交叉韧带重建时采集半腱肌和股薄肌腱是否会影响膝关节屈肌的机电延迟。

研究设计

病例对照研究;证据水平,3 级。

方法

作者评估了 12 例前交叉韧带重建患者(自体半腱肌和股薄肌腱),在重建后 2 年,并与 12 名健康对照者进行了比较。每位参与者在 1 分钟的休息时间内进行 4 次最大爆发力等长收缩。在收缩过程中,从双腿记录股二头肌和半腱肌的表面肌电图活动。

结果

统计比较显示,膝关节前交叉韧带重建后的机电延迟明显增加,这两种研究中的肌肉都是如此。具体来说,与健侧膝关节相比,重建侧膝关节的股二头肌(P =.029)和半腱肌(P =.005)的机电延迟值均增加。与健康对照组相比,重建侧膝关节的前交叉韧带重建后,这两种肌肉的差异均有统计学意义(半腱肌,P =.011;股二头肌,P =.024)。

结论

结果表明,前交叉韧带重建时采集半腱肌和股薄肌腱会显著增加膝关节屈肌的机电延迟。腘绳肌机电延迟的增加可能会通过改变肌肉张力向胫骨的传递时间来损害膝关节的稳定性和运动表现,从而影响运动活动中突然运动时的肌肉反应。然而,需要进一步的研究来确定腘绳肌机电延迟的增加是否会对最佳运动表现产生实际影响,并增加前交叉韧带重建运动员的膝关节受伤风险。

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