Peebles Alexander T, Miller Thomas K, Moskal Joseph T, Queen Robin M
Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, United States.
Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA 24018, United States.
Clin Biomech (Bristol). 2019 Dec;70:66-71. doi: 10.1016/j.clinbiomech.2019.08.002. Epub 2019 Aug 5.
There is currently no consensus among orthopaedic surgeons as to when patients with anterior cruciate ligament reconstruction are ready to return to sport or whether or not patients should wear a functional knee brace during athletic activity. The purpose of the present study was to determine the effects of time since return to sport and of a functional knee brace on hop distance and loading symmetry during hop testing in patients with anterior cruciate ligament reconstruction.
Twenty-eight patients with anterior cruciate ligament reconstruction completed hop testing after being released to return to sport and again 3 months later, both with and without wearing a custom fit extension constraint functional knee brace. The loadsol® captured plantar loading data (100 Hz) to quantify peak impact force, loading rate, and impulse during the final landing of every hop test. A limb symmetry index was calculated between surgical and non-surgical limbs for hop distance and loading measures.
Wearing a knee brace increased hop distance symmetry during the single and crossover hop tests and peak impact force symmetry on each test (all p < 0.05). While single (p = 0.022) and triple (p = 0.002) hop distance symmetry increased with time, there was no effect of time on any loading symmetry outcomes.
These results support using a functional knee brace during athletic activities for improving symmetry in the early return to sport period. These results also support previous findings that while hop distance symmetry improves with time, asymmetrical landing mechanics do not and should be addressed clinically.
目前，骨科医生对于前交叉韧带重建患者何时准备好恢复运动，或者患者在体育活动期间是否应佩戴功能性膝关节支具尚未达成共识。本研究的目的是确定前交叉韧带重建患者恢复运动后的时间以及功能性膝关节支具对单腿跳测试中的单腿跳距离和负荷对称性的影响。
28例前交叉韧带重建患者在获准恢复运动后完成单腿跳测试，3个月后再次进行测试，测试时分别佩戴和不佩戴定制的可调节伸展限制功能性膝关节支具。Loadsol®采集足底负荷数据（100Hz），以量化每次单腿跳测试最后落地时的峰值冲击力、负荷率和冲量。计算手术侧和非手术侧肢体在单腿跳距离和负荷测量方面的肢体对称性指数。
佩戴膝关节支具可提高单腿跳和交叉单腿跳测试中的单腿跳距离对称性以及每次测试中的峰值冲击力对称性（所有p<0.05）。虽然单腿跳（p=0.022）和双腿跳（p=0.002）距离对称性随时间增加，但时间对任何负荷对称性结果均无影响。
这些结果支持在体育活动期间使用功能性膝关节支具，以改善早期恢复运动阶段的对称性。这些结果还支持先前的研究结果，即虽然单腿跳距离对称性随时间改善，但不对称的落地力学并未改善，应在临床上加以解决。
