School of Human Kinetics, University of Ottawa, 200 Lees Avenue, Ottawa, K1S 5S9, Canada.
School of Rehabilitation Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, K1S 5S9, Canada.
Knee Surg Sports Traumatol Arthrosc. 2019 Feb;27(2):636-645. doi: 10.1007/s00167-018-5189-7. Epub 2018 Oct 10.
The purpose of this study was to identify high-functioning anterior cruciate ligament-deficient patients and assess the effects of reconstruction on their self-reported functionality, muscle activations and biomechanical properties.
Twenty young and active patients participated pre- (11.5 ± 14.3 months post-injury) and again 10.5 ± 1.7 months post-reconstruction and were individually matched to 20 healthy controls. Participants completed hop and side cut movements while patient-related outcome measures, lower limb electromyography, kinetic, and whole body kinematic data were collected. One-dimensional statistical parametric mapping was used to test for group differences (healthy vs deficient; deficient vs reconstructed; reconstructed vs healthy).
When comparing healthy to anterior cruciate ligament-deficient participants, all questionnaires indicated significant lower subjective function while the only substantial biomechanical difference between these participants was a decreased knee extensor moment in both the hop (peak difference: 0.63 Nm/kg, p < 0.001) and side cut (peak difference: 0.76 Nm/kg, p < 0.001). When comparing patients' pre- and post-reconstruction, no biomechanical differences were observed whereas only half of the questionnaires (Tegner, Lysholm, KNEES-ADL, KNEES-Slackness, KNEES-Looseness, KNEES-Sport Behaviour, IKDC, and KOOS-QoL) indicated higher function in the reconstructed state. When comparing the reconstructed patients to the healthy participants, all questionnaires were still significantly higher in the healthy controls. The reconstructed group also had a smaller flexion angle (peak difference: 14.5°, p = 0.007) and knee extensor moment (peak difference: 0.62 Nm/kg, p < 0.001) during the hop and a smaller knee extensor moment (peak difference: 0.90 Nm/kg, p < 0.001) during the side-cut task.
At 10-months post-reconstruction, the current results indicate that in high-functioning anterior cruciate ligament-deficient patients, reconstruction had little impact on objective measures of functional ability during dynamic tasks although self-reported function was improved.
Therapeutic prospective cohort study, Level II.
本研究旨在确定高功能前交叉韧带缺失患者，并评估重建对其自我报告功能、肌肉激活和生物力学特性的影响。
20 名年轻活跃的患者在受伤前（11.5±14.3 个月）和重建后 10.5±1.7 个月再次参加，并与 20 名健康对照组进行个体匹配。参与者完成了跳跃和侧滑运动，同时收集了患者相关的结果测量、下肢肌电图、动力学和全身运动学数据。一维统计参数映射用于测试组间差异（健康与前交叉韧带缺失；前交叉韧带缺失与重建；重建与健康）。
与前交叉韧带缺失的参与者相比，所有问卷均表明主观功能显著降低，而这些参与者之间唯一实质性的生物力学差异是跳跃（峰值差异：0.63 Nm/kg，p<0.001）和侧滑（峰值差异：0.76 Nm/kg，p<0.001）中膝关节伸肌力矩减小。当比较患者重建前后时，没有观察到生物力学差异，而只有一半的问卷（Tegner、Lysholm、KNEES-ADL、KNEES-Slackness、KNEES-Looseness、KNEES-Sport Behaviour、IKDC 和 KOOS-QoL）表明重建状态下的功能更高。当将重建后的患者与健康参与者进行比较时，所有问卷在健康对照组中仍然明显更高。重建组在跳跃过程中还具有更小的屈曲角度（峰值差异：14.5°，p=0.007）和膝关节伸肌力矩（峰值差异：0.62 Nm/kg，p<0.001），在侧滑任务中膝关节伸肌力矩更小（峰值差异：0.90 Nm/kg，p<0.001）。
在重建后 10 个月，目前的结果表明，在高功能前交叉韧带缺失患者中，尽管自我报告的功能有所改善，但重建对动态任务中功能能力的客观测量几乎没有影响。
治疗性前瞻性队列研究，II 级。
