Culvenor Adam G, Collins Natalie J, Vicenzino Bill, Cook Jill L, Whitehead Timothy S, Morris Hayden G, Crossley Kay M
The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Australia; La Trobe University, Department of Physiotherapy, School of Allied Health, College of Science, Health and Engineering, Australia.
The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Australia; The University of Melbourne, Department of Mechanical Engineering, Australia.
J Sci Med Sport. 2016 Jul;19(7):518-23. doi: 10.1016/j.jsams.2015.07.008. Epub 2015 Jul 10.
Patellofemoral pain is a frequent and troublesome complication following anterior cruciate ligament reconstruction (ACLR), irrespective of graft source. Yet, little is known about the factors associated with patellofemoral pain following hamstring-tendon ACLR.
Retrospective analysis of potential patellofemoral pain predictors, and cross-sectional analysis of possible patellofemoral pain consequences.
Potential predictors (pre-injury patellofemoral pain and activity level, concomitant patellofemoral cartilage damage and meniscectomy, age, sex, and surgical delay) and consequences (hopping performance, quality of life, kinesiophobia, and return to sport rates and attitudes) of patellofemoral pain 12 months following hamstring-tendon ACLR were assessed in 110 participants using univariate and multivariate analyses.
Thirty-three participants (30%) had patellofemoral pain at 12 months post-ACLR. Older age at the time of ACLR was the only predictor of post-operative patellofemoral pain. Following ACLR, those with patellofemoral pain had a higher body mass index, and worse physical performance, quality of life, kinesiophobia and return to sport attitudes. Patellofemoral pain has a significant burden on individuals 12 months following hamstring-tendon ACLR.
Clinicians need to be cognisant of patellofemoral pain, particularly in older individuals and those with a higher body mass index. The importance of considering psychological factors that are not typically addressed during ACLR rehabilitation, such as kinesiophobia, quality of life and return to sport attitudes is emphasised.
无论移植物来源如何，髌股疼痛都是前交叉韧带重建（ACLR）后常见且棘手的并发症。然而，对于腘绳肌腱ACLR后与髌股疼痛相关的因素知之甚少。
对潜在的髌股疼痛预测因素进行回顾性分析，并对可能的髌股疼痛后果进行横断面分析。
采用单因素和多因素分析，对110名参与者评估腘绳肌腱ACLR术后12个月髌股疼痛的潜在预测因素（伤前髌股疼痛和活动水平、合并髌股软骨损伤和半月板切除术、年龄、性别和手术延迟）及后果（单腿跳表现、生活质量、运动恐惧、恢复运动率和态度）。
33名参与者（30%）在ACLR术后12个月出现髌股疼痛。ACLR时年龄较大是术后髌股疼痛的唯一预测因素。ACLR后，有髌股疼痛的患者体重指数更高，身体机能、生活质量、运动恐惧及恢复运动的态度更差。腘绳肌腱ACLR术后12个月，髌股疼痛给个体带来了显著负担。
临床医生需要认识到髌股疼痛，尤其是在年龄较大和体重指数较高的个体中。强调了考虑ACLR康复过程中通常未涉及的心理因素的重要性，如运动恐惧、生活质量和恢复运动的态度。
