Hohmann Erik, Bryant Adam, Tetsworth Kevin
Musculoskeletal Research Unit, Central Queensland University, PO Box 4045, Rockhampton, QLD, 4700, Australia.
Medical School, University of Queensland, St Lucia, Australia.
Arch Orthop Trauma Surg. 2016 Apr;136(4):477-83. doi: 10.1007/s00402-015-2392-6. Epub 2015 Dec 30.
Knee function, whether anterior cruciate ligament (ACL)-deficient or ACL-reconstructed, is related to many conditions, and no single biomechanical variable can be used to definitively assess knee performance. The purpose of this study was to investigate the relationship between extension and flexion muscle strength and knee function in patients prior and following ACL reconstruction.
44 ACL-deficient patients with a mean age of 26.6 years were tested between 3 and 6 months following an acute injury and 2 years following ACL reconstruction. All reconstructed patients underwent surgical reconstruction within 6 months of ACL injury using bone-patellar tendon and interference screws. The Cincinnati knee rating system was used to assess knee function. Muscle strength was assessed with the Biodex™ Dynamometer. Isokinetic concentric and eccentric flexion and extension peak torque (Nm/kg) was tested at three different speeds: 60°/s, 120°/s and 180°/s. Isometric strength was tested in 30° and 60° of knee flexion. Both the involved and non-involved legs were tested to calculate symmetry indices.
The mean Cincinnati score in the ACL-deficient patient was 62.0 ± 14.5 (range 36-84) and increased to 89.3 ± 9.5 (range 61-100) in the ACL-reconstructed patient. Significant relationships between knee function and muscle strength in the ACL-deficient group were observed for knee symmetry indices (r = 0.38-0.50, p = 0.0001-0.05). In the ACL-reconstructed group significant relationships between knee functionality were observed for isometric and isokinetic peak torque of the involved limb (r = 0.46-0.71, p = 0.0001-0.007).
The findings of this study suggest that neither extension nor flexion peak torque were correlates of knee function in the ACL-deficient knee. However, leg symmetry indices were correlated to knee function. In the ACL-reconstructed knee, knee symmetry indices were not related to knee function but extension and flexion isokinetic concentric and isometric peak torque were.
膝关节功能，无论前交叉韧带（ACL）损伤还是ACL重建后，都与多种情况相关，没有单一的生物力学变量可用于明确评估膝关节性能。本研究的目的是调查ACL重建前后患者的屈伸肌力量与膝关节功能之间的关系。
44例平均年龄26.6岁的ACL损伤患者在急性损伤后3至6个月以及ACL重建后2年接受测试。所有重建患者在ACL损伤后6个月内使用骨-髌腱和干涉螺钉进行手术重建。采用辛辛那提膝关节评分系统评估膝关节功能。使用Biodex™测力计评估肌肉力量。在三种不同速度下测试等速向心和离心屈伸峰值扭矩（Nm/kg）：60°/s、120°/s和180°/s。在膝关节屈曲30°和60°时测试等长力量。对患侧和非患侧腿都进行测试以计算对称指数。
ACL损伤患者的辛辛那提评分平均为62.0±14.5（范围36 - 84），ACL重建患者的评分增加到89.3±9.5（范围61 - 100）。在ACL损伤组中，观察到膝关节对称指数与膝关节功能和肌肉力量之间存在显著关系（r = 0.38 - 0.50，p = 0.0001 - 0.05）。在ACL重建组中，观察到患侧肢体的等长和等速峰值扭矩与膝关节功能之间存在显著关系（r = 0.46 - 0.71，p = 0.0001 - 0.007）。
本研究结果表明，在ACL损伤的膝关节中，屈伸峰值扭矩均与膝关节功能无关。然而，腿部对称指数与膝关节功能相关。在ACL重建的膝关节中，膝关节对称指数与膝关节功能无关，但屈伸等速向心和等长峰值扭矩与膝关节功能相关。
