半腱肌腱重建后腘绳肌的电机械延迟与运动员重返比赛。

Electromechanical delay of the hamstrings following semitendinosus tendon autografts in return to competition athletes.

机构信息

Canadian Sport Institute Calgary, 2500 University Drive NW, CalgaryAlberta, T2N 1N4, Canada.

Faculty of Kinesiology, The University of Calgary, Calgary, AB, Canada.

出版信息

Eur J Appl Physiol. 2021 Jul;121(7):1849-1858. doi: 10.1007/s00421-021-04639-y. Epub 2021 Mar 12.

Abstract

PURPOSE

Knee flexor electromechanical delay (EMD) has been proposed as a contributing factor to non-contact anterior cruciate ligament (ACL) injury risk and the semitendinosus (ST) autograft technique has been shown to impair knee flexor torque at large angles of knee flexion. The purpose of this study was to analyse the effects of ACL reconstruction (ACLR) using the ST tendon autograft technique on knee flexor EMD across the knee flexion range of motion, in athletes who had returned to competition.

METHODS

Athletes with ACLR (n = 8 females, n = 3 males, 1.7 ± 0.5 years post-surgery) and non-injured control athletes (n = 6 females, n = 4 males) performed rapid maximal voluntary contractions of isometric knee flexion and extension at 30°, 50°, 70°, 90°,and 105° of knee flexion. Electrical activity of the ST, biceps femoris (BF), vastus lateralis, and vastus medialis was recorded using surface electromyography.

RESULTS

No change in EMD for the knee flexors or extensors was observed across joint angles. Greater EMD was found only for the BF in the ACLR limb of injured athletes compared to the contralateral limb (P < 0.05). In post-hoc analysis, evidence of ST tendon regrowth was noted for only 2/11 athletes.

CONCLUSION

While the EMD-joint angle relationship appeared to be unaffected by ST tendon harvest for ACLR, the absence of ST tendon regrowth should be considered. Despite return to competition, greater BF EMD was found, which may impair knee joint stabilization capacity by delaying the transfer time of muscle tension to the tibia after ST autograft.

摘要

目的

膝关节屈肌机电延迟(EMD)被认为是导致非接触性前交叉韧带(ACL)损伤风险的一个因素,半腱肌腱(ST)自体移植物技术已被证明会在膝关节大范围弯曲时损害膝关节屈肌的扭矩。本研究的目的是分析使用 ST 肌腱自体移植物技术进行 ACL 重建(ACLR)对运动员重返比赛后整个膝关节活动范围内膝关节屈肌 EMD 的影响。

方法

接受 ACLR 的运动员(n=8 名女性,n=3 名男性,术后 1.7±0.5 年)和未受伤的对照组运动员(n=6 名女性,n=4 名男性)在膝关节 30°、50°、70°、90°和 105°时进行等长最大自主膝关节屈肌和伸肌快速最大随意收缩。使用表面肌电图记录 ST、股二头肌(BF)、股外侧肌和股中间肌的电活动。

结果

在关节角度范围内,膝关节屈肌和伸肌的 EMD 没有变化。与对侧肢体相比,受伤运动员 ACLR 肢体的 BF 屈肌 EMD 更大(P<0.05)。在事后分析中,仅在 2/11 名运动员中发现了 ST 肌腱再生的证据。

结论

尽管 ST 肌腱采集似乎对 ACLR 后的 EMD-关节角度关系没有影响,但应该考虑 ST 肌腱没有再生的情况。尽管重返比赛,但 BF 屈肌 EMD 更大,这可能会通过延迟 ST 自体移植物后肌肉张力向胫骨的传递时间来损害膝关节的稳定性。

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