Fundación García Cugat, Barcelona, Spain.
Artroscopia GC, Hospital Quirón, Plaza Alfonso Comín 5-7 Planta -1, 08023, Barcelona, Spain.
Knee Surg Sports Traumatol Arthrosc. 2018 Mar;26(3):976-982. doi: 10.1007/s00167-017-4572-0. Epub 2017 May 13.
Muscular impairment, particularly for the gluteus maximus (GM), has been observed in femoroacetabular impingement (FAI). The purpose of this study was to evaluate the tensiomyographic changes of the GM, rectus femoris (RF) and adductor longus (AL) before and after arthroscopic surgery for FAI. It was hypothesized that arthroscopic treatment of FAI would improve the preoperative muscular impairment.
All patients undergoing arthroscopic treatment of FAI between January and July 2015 were approached for eligibility. Patients included had a tensiomyography (TMG) evaluation including maximal displacement (Dm) and contraction time (Tc) of these muscles in both lower extremities. TMG values between the injured and healthy sides were compared at the preoperative and post-operative (3, 6 and 12 months after surgery) periods.
There were no significant differences for the RF and AL, and Dm of the GM for any of the comparisons (n.s.). However, GM Tc was significantly lower at 3 (p = 0.016), 6 (p = 0.008), and 12 (p = 0.049) months after surgery in the injured side compared to preoperatively. GM Tc of the healthy side was significantly lower than the injured side at the preoperative period (p = 0.004) and at 3 (p = 0.024) and 6 (p = 0.028) months after surgery, but these significant differences were no longer observed at 12 months after surgery (n.s.). There was a significant reduction of pain in the GM area at 1 year after surgery compared to preoperatively (p < 0.0001).
Arthroscopic treatment of FAI and the subsequent rehabilitation improves contraction velocity of the GM of the injured side. Despite Tc is elevated in the GM of the injured compared to the healthy side preoperatively and at 3 and 6 months after surgery, differences in Tc between both sides are no longer significant at 12 months. Athletes with FAI participating in sports with great involvement of GM may benefit from arthroscopic treatment and its subsequent rehabilitation. TMG can be used as an objective measurement to monitor muscular improvements of the GM after surgery in these patients.
II.
在股骨髋臼撞击症（FAI）中观察到臀大肌（GM）的肌肉功能障碍。本研究的目的是评估 FA 关节镜手术后 GM、股直肌（RF）和长收肌（AL）的 tensiomyographic 变化。假设 FA 关节镜治疗会改善术前肌肉功能障碍。
所有 2015 年 1 月至 7 月接受 FA 关节镜治疗的患者均被纳入研究。所有患者均接受 tensiomyography（TMG）评估，包括双侧下肢 GM 的最大位移（Dm）和收缩时间（Tc）。在术前、术后（术后 3、6 和 12 个月）比较受伤侧和健康侧的 TMG 值。
RF 和 AL 以及 GM 的 Dm 在任何比较中均无显著差异（n.s.）。然而，GM Tc 在术后 3 个月（p = 0.016）、6 个月（p = 0.008）和 12 个月（p = 0.049）时明显低于术前。健康侧 GM Tc 在术前明显低于受伤侧（p = 0.004），术后 3 个月（p = 0.024）和 6 个月（p = 0.028）时明显低于受伤侧，但术后 12 个月时这些差异无统计学意义（n.s.）。术后 1 年 GM 区疼痛明显减轻（p < 0.0001）。
FAI 的关节镜治疗和随后的康复改善了受伤侧 GM 的收缩速度。尽管 GM 的 Tc 在术前以及术后 3 个月和 6 个月时均高于健康侧，但在术后 12 个月时两侧 Tc 之间的差异不再具有统计学意义。参与 GM 参与度大的运动的 FAI 运动员可能受益于关节镜治疗及其随后的康复。TMG 可作为监测这些患者术后 GM 肌肉改善的客观指标。
II 级。
