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运动员孤立性外侧半月板切除术后的着陆适应。

Landing adaptations following isolated lateral meniscectomy in athletes.

机构信息

Cincinnati Children's Hospital Medical Center Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH 45229, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2011 Oct;19(10):1716-21. doi: 10.1007/s00167-011-1490-4. Epub 2011 Apr 6.

Abstract

PURPOSE

Objective functional outcomes following isolated radial lateral meniscus tears in the athlete between the ages of 14-25 are not clearly defined. The objective of this study was to determine whether patients following lateral meniscectomy demonstrate lower extremity asymmetries relative to control athletes 3 months after surgery. We hypothesized that following lateral meniscectomy, athletes aged 14-25 years old would demonstrate altered landing biomechanics compared to sex, age, height, weight, and sport-matched controls.

METHODS

A total of 18 subjects were included in this study. Nine patients (7 men and 2 women, 20.1 ± 2.8 years) who had undergone first-time isolated radial lateral meniscus tears were tested 3 months following partial lateral meniscectomies and compared to nine sex, age, height, weight, and sport-matched controls (7 men and 2 women, 19.7 ± 3.1 years). A ten-camera motion analysis system and two force platforms were used to collect three trials of bilateral drop landings. A 2X2 ANOVA was used to test the interaction between side (involved vs. uninvolved) and group (patient vs. control).

RESULTS

The patient group landed with a decreased internal knee extensor moment compared to the uninvolved side and controls (interaction P < 0.05). The involved limb quadriceps isokinetic torque was not decreased compared to the contralateral or control (n.s.). Decreased knee extensor moments were significantly associated with reduced measures of function (IKDC scores: r = 0.69; P < 0.05).

CONCLUSIONS

Athletes who return to sport at approximately 3 months following a partial lateral meniscectomy may employ compensation strategies during landing as evidenced by reduced quadriceps recruitment and functional outcome scores. Clinicians should focus on improving quadriceps function during landing on the involved leg in an attempt to decrease residual limb asymmetries.

LEVEL OF EVIDENCE

Case-control study, Level III.

摘要

目的

在 14-25 岁的运动员中,孤立性桡侧外侧半月板撕裂后的客观功能结果尚不清楚。本研究的目的是确定在手术后 3 个月,行外侧半月板切除术的患者与对照组运动员相比,下肢是否存在不对称。我们假设,在外侧半月板切除术后,14-25 岁的运动员与性别、年龄、身高、体重和运动匹配的对照组相比,会表现出改变的着陆生物力学。

方法

本研究共纳入 18 名受试者。9 名患者(7 名男性和 2 名女性,20.1±2.8 岁)首次接受了孤立性桡侧外侧半月板撕裂,在接受部分外侧半月板切除术 3 个月后进行了测试,并与 9 名性别、年龄、身高、体重和运动匹配的对照组(7 名男性和 2 名女性,19.7±3.1 岁)进行了比较。使用 10 个摄像头运动分析系统和两个力台收集了双侧下落着陆的 3 次试验。采用 2X2 ANOVA 检验侧别(患侧与非患侧)和组间(患者与对照组)的相互作用。

结果

与非受累侧和对照组相比,患者组的膝关节内收肌力矩减小(交互 P<0.05)。受累侧股四头肌等速扭矩与对侧或对照组相比并未降低(无统计学差异)。膝关节伸肌力矩的减小与功能测量值的降低显著相关(IKDC 评分:r=0.69;P<0.05)。

结论

在接受部分外侧半月板切除术后约 3 个月重返运动的运动员,在着陆时可能会采用代偿策略,表现为股四头肌募集减少和功能评分降低。临床医生应在患侧着陆时,重点提高股四头肌功能,以试图减少残余肢体的不对称。

证据等级

病例对照研究,III 级。

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