Clinic of Rehabilitation, Faculty of Health and Sciences, Jagiellonian University Medical College, Cracow, Poland.
Department of Orthopaedic, Cracow Rehabilitation and Orthopaedic Centre, Cracow, Poland.
Med Sci Monit. 2020 May 12;26:e921003. doi: 10.12659/MSM.921003.
BACKGROUND The aim of this study was to compare the level of functional condition in patients who had rehabilitation with the comprehensive early rehabilitation program (CERP) following either single bundle (SB) or double bundle (DB) anterior cruciate ligament reconstruction (ACLR) using semitendinosus-gracilis tendon graft (ST-G) method. We hypothesized that 12 weeks after reconstruction followed by a rehabilitation program, there would be a difference in clinical results and functional activity between patients. MATERIAL AND METHODS This study included 94 patients who had rehabilitation with CERP after knee surgery for a knee injury from a recreational sport. There were 49 patients in Group 1 (mean age, 36.5 years) who had CERP after SB ACLR, and 45 patients in Group 2 (mean age, 35.6 years) who had CERP after DB ACLR. Functional condition was tested using the Lysholm Knee Scoring Scale, and knee stability was measured using KT-2000. The first examination was performed before CERP and the second examination was performed 12 weeks later. RESULTS The level of functional condition in both groups was similar before rehabilitation with CERP, with no significant difference (P<0.958) and was considered relatively low. In the second examination, 12 weeks after starting CERP, the patients improved in both groups. The improvement was larger in the SB ACLR Group 1 than in the DB ACLR Group 2. The difference was significant (P<0.005). However, the patients in Group 2 achieved better knee stability scores in the KT-2000 examination than the patients in Group 1. The difference was significant (P=0.035). CONCLUSIONS We found that the patients from both groups after 12 weeks of CERP achieved an improvement in stability and functional activity within normal limits. However, SB ACLR was more effective than DB ACLR in terms of the level of functionality achieved with CERP but was less effective in terms of knee stability.
本研究旨在比较使用半腱肌腱-股薄肌腱(ST-G)移植物重建前交叉韧带(ACL)后,分别采用单束(SB)或双束(DB)重建的患者,在接受综合早期康复方案(CERP)康复后的功能状况水平。我们假设在重建后 12 周接受康复计划后,患者的临床结果和功能活动会存在差异。
本研究纳入了 94 例因膝关节运动损伤接受膝关节手术后接受 CERP 康复的患者。其中,SB-ACL 重建后接受 CERP 的患者 49 例(平均年龄 36.5 岁),DB-ACL 重建后接受 CERP 的患者 45 例(平均年龄 35.6 岁)。采用 Lysholm 膝关节评分量表测试功能状况,采用 KT-2000 测量膝关节稳定性。第一次检查在接受 CERP 前进行,第二次检查在 12 周后进行。
在接受 CERP 康复前,两组患者的功能状况相似,无显著差异(P<0.958),且功能状况相对较低。在第二次检查中,即接受 CERP 康复 12 周后,两组患者均有所改善。SB-ACL 重建组(Group 1)的改善程度大于 DB-ACL 重建组(Group 2),差异有统计学意义(P<0.005)。然而,在 KT-2000 检查中,DB-ACL 重建组的患者膝关节稳定性评分优于 SB-ACL 重建组。差异有统计学意义(P=0.035)。
我们发现,两组患者在接受 12 周的 CERP 康复后,稳定性和功能活动均有所改善,且在正常范围内。然而,在功能状况的恢复方面,SB-ACL 重建比 DB-ACL 重建更有效,但在膝关节稳定性方面效果较差。