Holsgaard-Larsen A, Jensen C, Mortensen N H M, Aagaard P
Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Denmark.
Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Denmark.
Knee. 2014 Jan;21(1):66-73. doi: 10.1016/j.knee.2013.06.002. Epub 2013 Jul 5.
Full recovery in muscle strength and functional performance may not be achieved after ACL-injury.
The aim of this study is to investigate loading patterns during jumping, muscle function and functional performance in ACL-reconstructed patients and to investigate the origin of between-limb asymmetry by means of a 3-dimensional movement analysis. Design is cross-sectional.
23 ACL-reconstructed men (27.2±7.5 years, BMI: 25.4±3.2) 27±7 month post-surgery and 25 matched controls (27.2±5.4 years, BMI: 24.1±1.8) were included. Participants performed (i) bilateral and (ii) unilateral counter movement jumps (CMJ). A 3-D movement analysis was performed by a six-camera Vicon MX-system. Subsequently, jump height (JH), knee joint range of motion (ROM), peak and mean sagittal knee moments were analyzed (iii) one-leg maximal jump for distance was performed, and (iv) maximal unilateral isometric knee extensor and flexor strength (MVC) were measured using stabilized dynamometry.
No in-between group differences in age or BMI were observed. CMJ: Between-limb asymmetry ratios for ROM differed (p<0.01) between patients and controls in both types of CMJ (96.1% vs. 102.6% and 87.0% vs. 99.9% in bilateral and single-leg CMJs, respectively). Jump for distance: Patients demonstrated greater (p<0.01) asymmetry for jump length (92.9% vs. 98.6%). MVC: Asymmetry in hamstring MVC was greater (p<0.001) for patients than controls (77.4% vs. 101.3%).
ACL-patients showed reduced function of the operated leg~2 years post ACL-reconstruction, especially for hamstring MVC. Hamstrings are important protagonists to the ACL, thus representing a potential risk factor for secondary ACL-rupture and/or osteoarthritis.
前交叉韧带损伤后，肌肉力量和功能表现可能无法完全恢复。
本研究旨在调查前交叉韧带重建患者跳跃时的负荷模式、肌肉功能和功能表现，并通过三维运动分析研究双侧肢体不对称的根源。设计为横断面研究。
纳入23名前交叉韧带重建术后27±7个月的男性患者（年龄27.2±7.5岁，体重指数：25.4±3.2）和25名匹配的对照组（年龄27.2±5.4岁，体重指数：24.1±1.8）。参与者进行（i）双侧和（ii）单侧反向跳跃（CMJ）。通过六台摄像机的Vicon MX系统进行三维运动分析。随后，分析跳跃高度（JH）、膝关节活动范围（ROM）、矢状面膝关节峰值和平均力矩（iii）进行单腿跳远测试，（iv）使用稳定测力计测量最大单侧等长膝关节伸肌和屈肌力量（MVC）。
两组在年龄或体重指数方面未观察到组间差异。CMJ：在两种类型的CMJ中，患者和对照组之间ROM的双侧肢体不对称率存在差异（p<0.01）（双侧和单腿CMJ中分别为96.1%对102.6%和87.0%对99.9%）。跳远：患者在跳远长度方面表现出更大的不对称性（p<0.01）（92.9%对98.6%）。MVC：患者腘绳肌MVC的不对称性大于对照组（p<0.001）（77.4%对101.3%）。
前交叉韧带重建术后约2年，前交叉韧带损伤患者手术侧肢体功能下降，尤其是腘绳肌MVC。腘绳肌是前交叉韧带的重要协同肌，因此是继发性前交叉韧带断裂和/或骨关节炎的潜在危险因素。
