Hart Harvi F, Collins Natalie J, Ackland David C, Crossley Kay M
Department of Physiotherapy, The University of Melbourne, Australia; Department of Mechanical Engineering; The University of Melbourne, Australia.
Department of Mechanical Engineering; The University of Melbourne, Australia.
J Sci Med Sport. 2015 Sep;18(5):512-7. doi: 10.1016/j.jsams.2014.09.011. Epub 2014 Sep 30.
To compare knee confidence and kinesiophobia (fear of re-injury) in those with and without knee osteoarthritis following anterior cruciate ligament reconstruction, and determine whether poorer knee confidence is associated with greater kinesiophobia, worse knee-related symptoms, and functional impairments in those with knee osteoarthritis.
Cross-sectional.
Sixty-six individuals, 5-12 years following anterior cruciate ligament reconstruction, with (n=30) and without (n=36) knee osteoarthritis were included. Knee injury and Osteoarthritis Outcome Score quality-of-life question (Q3), assessed knee confidence and Tampa Scale of Kinesiophobia assessed kinesiophobia. In the osteoarthritis group, knee-related symptoms (International Knee Documentation Committee and Anterior Knee Pain Scale), self-reported function (Knee injury and Osteoarthritis Outcome Score activities daily living), sport/recreation (Knee injury and Osteoarthritis Outcome Score-sport and recreation), and performance-based function (hopping, one leg rise tasks) were assessed. Between-group differences in knee confidence and kinesiophobia were evaluated with the Chi square test and analysis of variance, respectively. In the osteoarthritis group, between-group differences (none, mild/moderate and severe/extreme problems with knee confidence) in kinesiophobia, symptoms and function were determined with analysis of variances: p<0.05.
Following anterior cruciate ligament reconstruction, participants with knee osteoarthritis had significantly worse knee confidence (p=0.010) and greater kinesiophobia (p=0.006) than those without osteoarthritis. In those with knee osteoarthritis, poorer knee confidence was significantly associated with worse symptoms (Anterior Knee Pain Scale, p=0.001; International Knee Documentation Committee, p<0.001), kinesiophobia (p=0.030), Knee injury and Osteoarthritis Outcome Score-activities of daily living (p=0.005), Knee injury and Osteoarthritis Outcome Score-sport and recreation (p=0.001), single-leg hop (p=0.011), side-to-side hop (p=0.013) and one leg rise (p=0.001).
Psychological impairments are evident in people with knee osteoarthritis following anterior cruciate ligament reconstruction, compared to those without. Future studies should further investigate the psychological impairments associated with knee osteoarthritis after anterior cruciate ligament reconstruction.
比较前交叉韧带重建术后患膝骨关节炎和未患膝骨关节炎者的膝关节信心和运动恐惧（害怕再次受伤），并确定膝关节信心较差是否与膝骨关节炎患者更严重的运动恐惧、更差的膝关节相关症状及功能障碍有关。
横断面研究。
纳入66例前交叉韧带重建术后5至12年的个体，其中患膝骨关节炎者30例，未患膝骨关节炎者36例。膝关节损伤和骨关节炎结局评分生活质量问题（Q3）用于评估膝关节信心，坦帕运动恐惧量表用于评估运动恐惧。在骨关节炎组中，评估膝关节相关症状（国际膝关节文献委员会和前膝痛量表）、自我报告功能（膝关节损伤和骨关节炎结局评分日常生活活动）、运动/娱乐（膝关节损伤和骨关节炎结局评分-运动和娱乐）以及基于表现的功能（单腿跳、单腿起立任务）。分别采用卡方检验和方差分析评估膝关节信心和运动恐惧的组间差异。在骨关节炎组中，采用方差分析确定运动恐惧、症状和功能的组间差异（膝关节信心无问题、轻度/中度问题和重度/极重度问题）：p<0.05。
前交叉韧带重建术后，患膝骨关节炎的参与者膝关节信心明显更差（p=0.010），运动恐惧更严重（p=0.006）。在膝骨关节炎患者中，较差的膝关节信心与更差的症状（前膝痛量表，p=0.001；国际膝关节文献委员会，p<0.001）、运动恐惧（p=0.030）、膝关节损伤和骨关节炎结局评分-日常生活活动（p=0.005）、膝关节损伤和骨关节炎结局评分-运动和娱乐（p=0.001）、单腿跳（p=0.011）、侧向跳（p=0.013）和单腿起立（p=0.001）显著相关。
与未患膝骨关节炎者相比，前交叉韧带重建术后膝骨关节炎患者存在明显的心理障碍。未来的研究应进一步调查前交叉韧带重建术后与膝骨关节炎相关的心理障碍。
