Kim Hyun-Jung, Lee Jin-Hyuck, Ahn Sung-Eun, Park Min-Ji, Lee Dae-Hee
Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
Department of Sports Medical Center, Korea University College of Medicine, Seoul, Korea.
PLoS One. 2016 Jan 8;11(1):e0146234. doi: 10.1371/journal.pone.0146234. eCollection 2016.
Theoretical compensation after anterior cruciate ligament (ACL) tear could cause quadriceps weakness and hamstring activation, preventing anterior tibial subluxation and affecting the expected hamstring-to-quadriceps ratio. Although quadriceps weakness often occurs after ACL tears, it remains unclear whether hamstring strength and hamstring-to-quadriceps ratio increase in ACL deficient knees. This meta-analysis compared the isokinetic muscle strength of quadriceps and hamstring muscles, and the hamstring-to-quadriceps ratio, of the injured and injured limbs of patients with ACL tears. This meta-analysis included all studies comparing isokinetic thigh muscle strengths and hamstring-to-quadriceps ratio in the injured and uninjured legs of patients with ACL tear, without or before surgery. Thirteen studies were included in the meta-analysis. Quadriceps and hamstring strengths were 22.3 N∙m (95% CI: 15.2 to 29.3 N∙m; P<0.001) and 7.4 N∙m (95% CI: 4.3 to 10.5 N∙m; P<0.001) lower, respectively, on the injured than on the uninjured side. The mean hamstring-to-quadriceps ratio was 4% greater in ACL deficient than in uninjured limbs (95% CI: 1.7% to 6.3%; P<0.001). Conclusively, Decreases were observed in both the quadriceps and hamstring muscles of patients with ACL tear, with the decrease in quadriceps strength being 3-fold greater. These uneven reductions slightly increase the hamstring-to-quadriceps ratio in ACL deficient knees.
前交叉韧带（ACL）撕裂后的理论代偿可能会导致股四头肌无力和腘绳肌激活，从而防止胫骨前移并影响预期的腘绳肌与股四头肌比例。尽管ACL撕裂后常出现股四头肌无力，但ACL损伤膝关节的腘绳肌力量及腘绳肌与股四头肌比例是否增加仍不清楚。本荟萃分析比较了ACL撕裂患者患侧和健侧肢体的股四头肌和腘绳肌等速肌力以及腘绳肌与股四头肌比例。本荟萃分析纳入了所有比较ACL撕裂患者手术前或未手术时患侧和健侧大腿等速肌力以及腘绳肌与股四头肌比例的研究。荟萃分析纳入了13项研究。患侧股四头肌和腘绳肌力量分别比健侧低22.3 N∙m（95%CI：15.2至29.3 N∙m；P<0.001）和7.4 N∙m（95%CI：4.3至10.5 N∙m；P<0.001）。ACL损伤肢体的平均腘绳肌与股四头肌比例比未损伤肢体高4%（95%CI：1.7%至6.3%；P<0.001）。总之，观察到ACL撕裂患者的股四头肌和腘绳肌均有力量下降，股四头肌力量下降幅度是腘绳肌的3倍。这些不均衡的下降略微增加了ACL损伤膝关节的腘绳肌与股四头肌比例。
