Department of Orthopedic Surgery, Sanggye Paik Hospital, Inje University, Seoul, Korea.
Am J Sports Med. 2012 Jan;40(1):152-62. doi: 10.1177/0363546511424134. Epub 2011 Oct 12.
There are numerous reports on hamstring tendon regeneration after harvest for anterior cruciate ligament (ACL) reconstruction. However, few studies have evaluated the relationships among the magnetic resonance imaging (MRI) findings of hamstring regeneration, muscle strength, and functional results.
This study evaluates the correlations among the hamstring regeneration on MRI, flexor strength, and functional performance after hamstring tendon harvesting in ACL reconstruction.
Cohort study; Level of evidence, 3.
We enrolled 45 patients who underwent primary ACL reconstruction using hamstring tendon autografts and in whom flexor strength, functional performance, and preoperative and postoperative MRI results were evaluated at least 2 years postoperatively. Isokinetic flexion strength was tested in the standard and prone positions. We evaluated the differences in flexor strength and functional performance according to the number of regenerated tendons. The correlation between the MRI findings (the number of regenerated hamstring tendons and proximal shift of the musculotendinous junction) and the functional performance and flexor strength was analyzed.
The patients were divided into 3 groups according to the regeneration of the hamstring tendons on MRI: both semitendinosus and gracilis tendons regenerated (group SG), only 1 tendon regenerated (group O), and no tendon regenerated (group N). Significant differences were found in the flexor deficit between group N and groups SG and O on the standard and prone position isokinetic tests. There was a significant correlation (ρ = -.472) between the number of regenerated hamstring tendons and the carioca test result. The proximal shift significantly correlated with the flexor deficit in the prone position isokinetic test (semitendinosus, r = .449; gracilis, r = .366).
Hamstring tendons regenerated after harvest for ACL reconstruction in a high proportion of the patients. The flexor strength with both the standard and prone position isokinetic tests differed in the 3 groups. The number of regenerated hamstring tendons was significantly correlated with performance on the carioca test. Proximal shifting of the musculotendinous junction was significantly correlated with flexor deficit on the hyperflexion isokinetic test.
有大量关于腘绳肌腱在用于前交叉韧带（ACL）重建的肌腱取腱术后再生的报道。然而，很少有研究评估腘绳肌腱再生的磁共振成像（MRI）表现、肌肉力量和功能结果之间的关系。
本研究评估了 ACL 重建中腘绳肌腱取腱术后 MRI 所见的腘绳肌腱再生、屈肌力量和功能表现之间的相关性。
队列研究；证据水平，3 级。
我们纳入了 45 例接受了使用自体腘绳肌腱进行的初次 ACL 重建的患者，所有患者在术后至少 2 年进行了术前和术后 MRI 结果以及屈肌力量和功能表现的评估。采用等速测试在标准和俯卧位测试屈肌力量。我们根据再生肌腱的数量评估了屈肌力量和功能表现的差异。分析了 MRI 结果（再生的腘绳肌腱数量和肌腱肌腹结合部的近端移位）与功能表现和屈肌力量之间的相关性。
根据 MRI 上腘绳肌腱的再生情况，患者被分为 3 组：半腱肌和股薄肌肌腱均再生（SG 组）、仅 1 根肌腱再生（O 组）和无肌腱再生（N 组）。在标准和俯卧位等速测试中，N 组与 SG 组和 O 组之间的屈肌缺损存在显著差异。再生的腘绳肌腱数量与 carioca 测试结果呈显著相关（ρ=-.472）。肌腱肌腹结合部的近端移位与俯卧位等速测试中的屈肌缺损呈显著相关（半腱肌，r=.449；股薄肌，r=.366）。
在接受 ACL 重建的患者中，有很大一部分患者的腘绳肌腱发生了再生。3 组患者的标准和俯卧位等速测试的屈肌力量存在差异。再生的腘绳肌腱数量与 carioca 测试的表现显著相关。肌腱肌腹结合部的近端移位与俯卧位等速测试中的屈肌缺损显著相关。
