青少年运动相关膝关节损伤后的健康相关结局。
Health-related Outcomes after a Youth Sport-related Knee Injury.
机构信息
Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, AB, CANADA.
Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, AB, CANADA.
出版信息
Med Sci Sports Exerc. 2019 Feb;51(2):255-263. doi: 10.1249/MSS.0000000000001787.
PURPOSE
Active youth are vulnerable to knee injury and subsequent osteoarthritis. Improved understanding of the association between health-related outcomes and history of joint injury could inform osteoarthritis prevention strategies. The purpose of this historical cohort study is to examine the association between youth sport-related knee injury and various clinical, physiological, behavioral, and functional health-related outcomes, 3-10 yr postinjury.
METHODS
Participants included 100 individuals who experienced a youth sport-related knee injury 3-10 yr earlier and 100 age-, sex-, and sport-matched uninjured controls. Outcomes include the following: Knee Injury and Osteoarthritis Outcome Score (KOOS), Intermittent and Constant Osteoarthritis Pain Score, body mass index (BMI), fat mass index (FMI), weekly physical activity, estimated aerobic capacity, hip and knee muscle strength, and dynamic balance. Baseline characteristics were described. Multivariable regression models (95% confidence interval [CI]) were used to evaluate the association between injury history and each outcome, considering the influence of sex and time since injury.
RESULTS
Participant median age was 22 yr (range, 15-26 yr), and 55% were female. The injured group demonstrated poorer KOOS subscale scores, more total and intermittent pain, higher BMI (1.8 kg·m; 95% CI = 0.9-2.6), higher FMI (1.1 kg·m; 95% CI = 0.5-1.6), weaker knee extensor (-0.18 N·m·kg; 95% CI = -0.33 to -0.02) and flexor (-0.21 N·m·kg; 95% CI = -0.30 to -0.11) muscles, and poorer balance than controls. In the previously injured group, female sex was associated with poorer KOOS quality-of-life scores, knee flexor strength, and greater FMI, whereas longer time since injury was associated with poorer KOOS symptoms scores, knee extensor strength, and balance outcomes.
CONCLUSION
Youth that suffer a sport-related knee injury demonstrate on average more negative health-related outcomes consistent with future osteoarthritis compared with uninjured matched controls 3-10 yr after injury. These negative outcomes differ by sex and time since injury.
目的
活跃的年轻人易患膝关节损伤和随后的骨关节炎。更好地了解健康相关结果与关节损伤史之间的关系，可以为骨关节炎的预防策略提供信息。本历史队列研究的目的是检查青年运动相关膝关节损伤与各种临床、生理、行为和功能健康相关结果之间的关系，这些结果在损伤后 3-10 年进行评估。
方法
参与者包括 100 名在 3-10 年前经历过青年运动相关膝关节损伤的患者和 100 名年龄、性别和运动匹配的未受伤对照组。结果包括：膝关节损伤和骨关节炎结局评分（KOOS）、间歇性和持续性骨关节炎疼痛评分、体重指数（BMI）、脂肪质量指数（FMI）、每周体育活动、估计有氧能力、髋关节和膝关节肌肉力量以及动态平衡。描述了基线特征。多变量回归模型（95%置信区间[CI]）用于评估损伤史与每种结果之间的关系，同时考虑性别和损伤后时间的影响。
结果
参与者的中位年龄为 22 岁（范围，15-26 岁），55%为女性。受伤组的 KOOS 亚量表评分较差，总疼痛和间歇性疼痛更多，BMI 较高（1.8kg·m；95%CI=0.9-2.6），FMI 较高（1.1kg·m；95%CI=0.5-1.6），膝关节伸肌（-0.18N·m·kg；95%CI=-0.33 至 -0.02）和屈肌（-0.21N·m·kg；95%CI=-0.30 至 -0.11）力量较弱，平衡能力较差。在受伤组中，女性性别与 KOOS 生活质量评分、膝关节屈肌力量和更大的 FMI 较差有关，而受伤后时间较长与 KOOS 症状评分、膝关节伸肌力量和平衡结果较差有关。
结论
与未受伤的匹配对照组相比，在运动相关膝关节损伤后 3-10 年，患有运动相关膝关节损伤的年轻人平均表现出更多与未来骨关节炎一致的负面健康相关结果。这些负面结果因性别和受伤后时间而异。
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