前交叉韧带断裂合并外侧半月板撕裂的患者，其动态姿势稳定性比内侧半月板撕裂的患者更差。
Poorer dynamic postural stability in patients with anterior cruciate ligament rupture combined with lateral meniscus tear than in those with medial meniscus tear.
作者信息
Lee Jin Hyuck, Lee Dae-Hee, Park Jong-Hoon, Suh Dong Won, Kim Eunseon, Jang Ki-Mo
机构信息
Department of Sports Medical Center, , Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
出版信息
Knee Surg Relat Res. 2020 Jan 1;32(1):8. doi: 10.1186/s43019-019-0027-x.
BACKGROUND
Only limited data are available regarding postural stability between anterior cruciate ligament (ACL)-injured patients with medial meniscus (MM) tear and those with lateral meniscus (LM) tear. The purpose of this study was to compare preoperative postural stability for both involved and uninvolved knees in ACL rupture combined with MM and LM tears. It was hypothesized that there would be a significant difference in postural stability between these two groups.
METHODS
Ninety-three ACL-injured patients (53 combined with MM tears vs. 40 combined with LM tears) were included. Static and dynamic postural stability were evaluated with the overall stability index (OSI), anterior-posterior stability index (APSI), and medial-lateral stability index (MLSI) using stabilometry. Knee muscle strength was evaluated using an isokinetic testing device.
RESULTS
In the static postural stability test, none of the stability indices showed significant differences between the two groups for both knees (p > 0.05). In the dynamic postural stability test for involved side knees, the OSI and APSI were significantly higher in the LM tear group compared to the MM tear group (OSI: 2.0 ± 0.8 vs. 1.6 ± 0.5, p = 0.001; APSI: 1.5 ± 0.6 vs. 1.3 ± 0.5, p = 0.023), but not the MLSI (p > 0.05). In the static and dynamic postural stability tests in each group, there were no significant differences between the involved and uninvolved side knees (p > 0.05). There was no significant difference in the knee muscle strength between the two groups (p > 0.05). All postural stability showed no significant correlation with knee muscle strength (p > 0.05).
CONCLUSION
Dynamic postural stability was poorer in patients with ACL rupture combined with LM tear than in those with MM tear. Therefore, close monitoring for postural stability would be necessary during preoperative and postoperative rehabilitation, especially for patients with ACL rupture combined with LM tear.
LEVEL OF EVIDENCE
LEVEL III.
背景
关于前交叉韧带（ACL）损伤合并内侧半月板（MM）撕裂和外侧半月板（LM）撕裂患者的姿势稳定性，仅有有限的数据。本研究的目的是比较ACL断裂合并MM和LM撕裂患者患侧和未患侧膝关节术前的姿势稳定性。研究假设这两组患者的姿势稳定性存在显著差异。
方法
纳入93例ACL损伤患者（53例合并MM撕裂，40例合并LM撕裂）。使用稳定测量法通过整体稳定性指数（OSI）、前后稳定性指数（APSI）和内外侧稳定性指数（MLSI）评估静态和动态姿势稳定性。使用等速测试设备评估膝关节肌肉力量。
结果
在静态姿势稳定性测试中，两组患侧和未患侧膝关节的稳定性指标均无显著差异（p>0.05）。在患侧膝关节的动态姿势稳定性测试中，LM撕裂组的OSI和APSI显著高于MM撕裂组（OSI：2.0±0.8 vs. 1.6±0.5，p = 0.001；APSI：1.5±0.6 vs. 1.3±0.5，p = 0.023），但MLSI无显著差异（p>0.05）。在每组的静态和动态姿势稳定性测试中，患侧和未患侧膝关节之间无显著差异（p>0.05）。两组之间的膝关节肌肉力量无显著差异（p>0.05）。所有姿势稳定性与膝关节肌肉力量均无显著相关性（p>0.05）。
结论
ACL断裂合并LM撕裂患者的动态姿势稳定性比合并MM撕裂患者差。因此，在术前和术后康复期间，尤其是对于ACL断裂合并LM撕裂的患者，有必要密切监测姿势稳定性。
证据水平
III级。
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