单束和双束前交叉韧带重建术后股四头肌激活对胫骨前移的动态影响
Dynamic Effect of Quadriceps Muscle Activation on Anterior Tibial Translation After Single-Bundle and Double-Bundle Anterior Cruciate Ligament Reconstruction.
作者信息
Tsarouhas Alexander, Giakas Giannis, Malizos Konstantinos N, Spiropoulos Giannis, Sideris Vasilios, Koutedakis Yiannis, Hantes Michael E
机构信息
Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Department of Physical Education and Sport Science, Center for Research and Technology of Thessaly, Trikala, Greece.
出版信息
Arthroscopy. 2015 Jul;31(7):1303-9. doi: 10.1016/j.arthro.2015.02.028. Epub 2015 Apr 14.
PURPOSE
To examine differences in anterior tibial translation in 3 groups: single-bundle anterior cruciate ligament (ACL)-reconstructed, double-bundle ACL-reconstructed, and ACL-intact knees under gradual dynamic quadriceps muscle activation.
METHODS
Thirty male patients underwent successful single-bundle (n = 15) and double-bundle (n = 15) ACL reconstructions; 15 healthy controls were included in the study. Anterior tibial translation was assessed at 30° of knee flexion in the resting position (0% quadriceps activation) and under 50% and 100% of maximum quadriceps concentric contraction using an isokinetic dynamometer with the KT-2000 arthrometer securely attached to the participants' knees.
RESULTS
The 2 ACL-reconstructed groups were similar regarding International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Score (KOOS), Tegner, and Lysholm scores and preliminary isokinetic evaluation (P = .38). Quadriceps activation significantly affected anterior tibial translation (P = .001, α = 0.98). In all 3 study groups, anterior tibial translation was significantly higher under 100% quadriceps activation compared with 0% contraction (P = .01) and 50% quadriceps activation (P = .047). There were no between-group differences in anterior tibial translation with 0%, 50%, or 100% quadriceps activation (P = .46).
CONCLUSIONS
Under quadriceps muscle activation, anteroposterior knee laxity in ACL-intact and ACL-reconstructed knees is gradually increased. Single-bundle and double-bundle ACL-reconstructed knees show a similar increase in anterior tibial translation under gradual quadriceps contraction. When comparing different ACL reconstruction techniques in the experimental setting, dynamic, in addition to static, testing is advised to reach a comprehensive assessment of anteroposterior knee stability.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
目的
研究三组膝关节在股四头肌逐渐动态激活情况下的胫骨前移差异，这三组分别为单束前交叉韧带（ACL）重建组、双束ACL重建组以及ACL完整组。
方法
30例男性患者成功接受了单束（n = 15）和双束（n = 15）ACL重建手术；15名健康对照者纳入本研究。使用等速测力计并将KT-2000关节测量仪牢固地连接到参与者的膝盖上，在休息位（股四头肌激活0%）以及最大股四头肌向心收缩的50%和100%时，于屈膝30°评估胫骨前移情况。
结果
在国际膝关节文献委员会（IKDC）、膝关节损伤和骨关节炎评分（KOOS）、 Tegner评分以及Lysholm评分和初步等速评估方面，两组ACL重建组相似（P = .38）。股四头肌激活显著影响胫骨前移（P = .001，α = 0.98）。在所有三个研究组中，与0%收缩（P = .01）和50%股四头肌激活相比，100%股四头肌激活时胫骨前移显著更高（P = .047）。股四头肌激活0%、50%或100%时，组间胫骨前移无差异（P = .46）。
结论
在股四头肌激活情况下，ACL完整和ACL重建膝关节的前后向松弛度逐渐增加。在股四头肌逐渐收缩时，单束和双束ACL重建膝关节的胫骨前移增加情况相似。在实验环境中比较不同的ACL重建技术时，建议除了静态测试外还进行动态测试，以全面评估膝关节前后向稳定性。
证据水平
III级，回顾性比较研究。
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