Welling Wouter, Benjaminse Anne, Lemmink Koen, Gokeler Alli
University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands; Medisch Centrum Zuid, Sportlaan 2-1, 9728 PH Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands; School of Sport Studies, Hanze University Groningen, Zernikeplein 17, 9747 AS Groningen, the Netherlands.
Knee. 2020 Jun;27(3):949-957. doi: 10.1016/j.knee.2020.03.007. Epub 2020 Apr 1.
A limited number of patients return to sport (RTS) after an anterior cruciate ligament reconstruction (ACLR) and patients who RTS have a relatively high risk for second ACL injury. The purpose of the current study was to compare the results of a test battery between patients who returned to the pre-injury level of sport (RTS group) and patients who did not (NO-RTS group). It was hypothesized that the RTS group showed better test results.
Sixty-four patients (age 27.8 ± 8.8 years) were included. The results of a multicomponent test battery (jump-landing task assessed with the Landing Error Scoring System (LESS), three hop tests, isokinetic strength test for quadriceps and hamstring) were compared between groups with a 2 × 2 ANOVA.
The RTS group showed a significantly lower LESS score (p = 0.010), significantly higher absolute scores on hop tests with both legs (injured leg: single leg hop test p = 0.013, triple leg hop test p = 0.024, side hop test p = 0.021; non-injured leg: single leg hop test p = 0.011, triple leg hop test p = 0.023, side hop test p = 0.032) and significantly greater hamstring strength in the injured leg (p = 0.009 at 60°/s, p = 0.012 at 180°/s and p = 0.013 at 300°/s). No differences in test results were identified between patients who sustained a second ACL injury and patients who did not.
Patients after ACLR with better jump-landing patterns, hop performance and greater hamstring strength have greater likelihood for RTS. However, our findings show that RTS criteria fail to identify patients who are at risk for a second ACL injury.
前交叉韧带重建(ACLR)术后仅有少数患者能够恢复运动(RTS),且恢复运动的患者再次发生前交叉韧带损伤的风险相对较高。本研究的目的是比较恢复到伤前运动水平的患者(RTS组)和未恢复到伤前运动水平的患者(非RTS组)之间一系列测试的结果。研究假设RTS组的测试结果更好。
纳入64例患者(年龄27.8±8.8岁)。采用2×2方差分析比较两组之间多成分测试系列(用落地误差评分系统(LESS)评估的跳落任务、三项跳跃测试、股四头肌和腘绳肌等速肌力测试)的结果。
RTS组的LESS评分显著更低(p = 0.010),双腿跳跃测试的绝对得分显著更高(伤侧腿:单腿跳跃测试p = 0.013,双腿跳跃测试p = 0.024,侧方跳跃测试p = 0.021;非伤侧腿:单腿跳跃测试p = 0.011,双腿跳跃测试p = 0.023,侧方跳跃测试p = 0.032),伤侧腿的腘绳肌力量显著更大(60°/s时p = 0.009,180°/s时p = 0.012,300°/s时p = 0.013)。在再次发生前交叉韧带损伤的患者和未发生再次损伤的患者之间未发现测试结果存在差异。
ACLR术后具有更好的跳落模式、跳跃表现和更强腘绳肌力量的患者恢复运动的可能性更大。然而,我们的研究结果表明,恢复运动的标准未能识别出有再次发生前交叉韧带损伤风险的患者。