Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, London, TW1 4SX, UK.
Isokinetic Medical Group, FIFA Medical Centre of Excellence, Education and Research Department, Bologna, Italy.
Sports Med. 2021 Apr;51(4):607-624. doi: 10.1007/s40279-020-01400-x. Epub 2020 Dec 17.
It is important to optimise the functional recovery process to enhance patient outcomes after major injury such as anterior cruciate ligament reconstruction (ACLR). This requires in part more high-quality original research, but also an approach to translate existing research into practice to overcome the research to implementation barriers. This includes research on ACLR athletes, but also research on other pathologies, which with some modification can be valuable to the ACLR patient. One important consideration after ACLR is the recovery of hamstring muscle function, particularly when using ipsilateral hamstring autograft. Deficits in knee flexor function after ACLR are associated with increased risk of knee osteoarthritis, altered gait and sport-type movement quality, and elevated risk of re-injury upon return to sport. After ACLR and the early post-operative period, there are often considerable deficits in hamstring function which need to be overcome as part of the functional recovery process. To achieve this requires consideration of many factors including the types of strength to recover (e.g., maximal and explosive, multiplanar not just uniplanar), specific programming principles (e.g., periodised resistance programme) and exercise selection. There is a need to know how to train the hamstrings, but also apply this to the ACLR athlete. In this paper, the authors discuss the deficits in hamstring function after ACLR, the considerations on how to restore these deficits and align this information to the ACLR functional recovery process, providing recommendation on how to recover hamstring function after ACLR.
优化功能恢复过程对于提高重大损伤（如前交叉韧带重建术）后的患者预后非常重要。这部分需要更多高质量的原始研究，但也需要将现有研究转化为实践，以克服研究到实施的障碍。这包括 ACLR 运动员的研究，但也包括其他病理学的研究，这些研究经过一些修改后对 ACLR 患者也有价值。ACL 重建术后的一个重要考虑因素是腘绳肌功能的恢复，特别是在使用同侧腘绳肌腱移植物时。ACL 重建术后膝关节屈肌功能的缺陷与膝关节骨关节炎风险增加、步态改变和运动类型运动质量下降以及重返运动时再次受伤的风险增加有关。在 ACLR 后和术后早期，腘绳肌功能通常会出现相当大的缺陷，需要在功能恢复过程中克服这些缺陷。要做到这一点，需要考虑许多因素，包括需要恢复的力量类型（例如，最大力量和爆发力，多平面而不仅仅是单平面）、特定的编程原则（例如，周期性阻力计划）和运动选择。需要知道如何训练腘绳肌，并且将其应用于 ACLR 运动员。在本文中，作者讨论了 ACLR 后腘绳肌功能的缺陷，以及如何恢复这些缺陷的考虑因素，并将这些信息与 ACLR 的功能恢复过程对齐，提供了关于如何在 ACLR 后恢复腘绳肌功能的建议。
