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采用对侧腘绳肌腱自体移植物有助于前交叉韧带重建后更快地恢复等速和等长力量:一项随机对照试验。

Utilizing a contralateral hamstring autograft facilitates earlier isokinetic and isometric strength recovery after anterior cruciate ligament reconstruction: a randomised controlled trial.

机构信息

Department of Orthopaedics, Stockholm South Hospital, Karolinska Institute, Stockholm, Sweden.

Capio Artro Clinic, FIFA Medical Centre of Excellence, Sophiahemmet Hospital, Valhallavägen 91, 11486, Stockholm, Sweden.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2684-2694. doi: 10.1007/s00167-021-06491-1. Epub 2021 Feb 18.

DOI:10.1007/s00167-021-06491-1
PMID:33604735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8298236/
Abstract

PURPOSE

To compare muscle strength and patient reported outcomes following ACLR using a semitendinosus (ST) graft from the ipsilateral (IL) leg compared to a graft from the contralateral (CL) leg.

METHODS

One-hundred and forty patients with an ACL injury were randomized to IL or CL ACLR. Patients were assessed at 6, 12 and 24 months with isokinetic and isometric muscle strength measured using Biodex. Patient-reported outcomes and manual stability measurements were also recorded.

RESULTS

Patient-related outcomes improved over time for both groups with no significant differences between groups at any time point. No differences between groups in objective knee assessment scores or rerupture rates were found. The IL group was significantly weaker in knee flexion strength at all time points compared to the CL group, additionally the IL group did not recover flexor strength within 2 years.

CONCLUSION

This study demonstrated that utilizing an ST graft harvested from the uninjured limb for ACLR facilitates early isokinetic and isometric strength recovery, with no significant adverse outcomes demonstrated in other measurements and therefore be performed to reduce the risk of long-term strength deficits in the injured leg LEVEL OF EVIDENCE: II.

摘要

目的

比较同侧(IL)和对侧(CL)腘绳肌腱(ST)移植物重建前交叉韧带(ACL)后肌肉力量和患者报告的结局。

方法

140 名 ACL 损伤患者被随机分配至 IL 或 CL ACLR。患者在 6、12 和 24 个月时使用 Biodex 进行等速和等长肌肉力量评估。还记录了患者报告的结局和手动稳定性测量结果。

结果

两组患者的患者相关结局随时间推移而改善,在任何时间点两组之间均无显著差异。两组之间在客观膝关节评估评分或再断裂率方面没有发现差异。与 CL 组相比,IL 组在所有时间点的膝关节屈曲力量均明显较弱,此外,IL 组在 2 年内未恢复屈肌力量。

结论

这项研究表明,在前交叉韧带重建中使用来自未受伤肢体的 ST 移植物可促进早期等速和等长力量恢复,在其他测量中未显示出显著的不良结果,因此可以进行这种手术以降低受伤腿长期力量缺陷的风险。

证据水平

II。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/00bb857c5e66/167_2021_6491_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/a78c9f6e39ab/167_2021_6491_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/b04e4f798243/167_2021_6491_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/f4e7b030a599/167_2021_6491_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/f59ec249e6f2/167_2021_6491_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/6493fc65ecd6/167_2021_6491_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/afe83e3917f9/167_2021_6491_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/00bb857c5e66/167_2021_6491_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/a78c9f6e39ab/167_2021_6491_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/b04e4f798243/167_2021_6491_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/f4e7b030a599/167_2021_6491_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/f59ec249e6f2/167_2021_6491_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/6493fc65ecd6/167_2021_6491_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/afe83e3917f9/167_2021_6491_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ff5/8298236/00bb857c5e66/167_2021_6491_Fig7_HTML.jpg

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