Division of Rehabilitation Medicine, Gunma University Hospital, Showa machi 3-39-15, Maebashi, Gunma, Japan.
Knee Surg Sports Traumatol Arthrosc. 2012 Jan;20(1):173-8. doi: 10.1007/s00167-011-1633-7. Epub 2011 Aug 3.
The objective of this study was to reveal the predicting factors for muscle recovery in the lower extremity after anterior cruciate ligament (ACL) reconstruction.
One hundred and thirty-five (135) patients who underwent ACL reconstruction using hamstring autograft were evaluated. Exclusion criteria were bilateral ACL injury, chondral treatment and multiple ligament injury. Nonanatomical single-bundle reconstruction (SB) was performed in 79 patients, and anatomical double-bundle reconstruction (DB) was performed in 56 patients. Strength of quadriceps and knee flexion muscles were assessed at 60°/s using a Cybex II dynamometer (Lumex, Ronkonkoma, NY) at 3, 6 and 9 months after ACL reconstruction. Anterior tibial translation and pivot shift test were also evaluated. The medical records were reviewed to extract the following information: age, gender, the amount of pre and postoperative KT 1000, technique of reconstruction (SB or DB) and postoperative knee rotation.
No significant difference of muscle recovery in the lower extremity was observed at any time point after ACL reconstruction between the SB and DB groups. The DB group showed significantly better postoperative antero-posterior and rotational knee laxity than the SB group. Logistic regression analysis showed significant correlation with only age and muscle recovery.
For clinical relevance, there is a risk of muscle recovery delay when ACL reconstruction is performed in elderly patients. Anatomical DB reconstruction resulted in significantly better knee stability, but had no positive effect on muscle recovery.
Retrospective study, Level II.
本研究旨在揭示前交叉韧带（ACL）重建后下肢肌肉恢复的预测因素。
对 135 例采用自体腘绳肌腱重建 ACL 的患者进行评估。排除标准为双侧 ACL 损伤、软骨治疗和多韧带损伤。79 例患者行非解剖学单束重建（SB），56 例患者行解剖学双束重建（DB）。ACL 重建后 3、6 和 9 个月，使用 Cybex II 测力计（Lumex，Ronkonkoma，NY）以 60°/s 的速度评估股四头肌和膝关节屈肌的力量。还评估了胫骨前移位和膝关节旋转试验。回顾病历以提取以下信息：年龄、性别、术前和术后 KT-1000 的差值、重建技术（SB 或 DB）和术后膝关节旋转。
SB 组和 DB 组在 ACL 重建后任何时间点的下肢肌肉恢复均无显著差异。DB 组的术后前后和旋转膝关节松弛度明显优于 SB 组。Logistic 回归分析显示仅与年龄和肌肉恢复有显著相关性。
就临床相关性而言，老年患者行 ACL 重建存在肌肉恢复延迟的风险。解剖学 DB 重建可显著改善膝关节稳定性，但对肌肉恢复无积极影响。
回顾性研究，II 级。
