OSU Sports Medicine Research Institute, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Department of Physical Therapy and Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Orthop Res. 2022 Jan;40(1):285-294. doi: 10.1002/jor.25029. Epub 2021 Apr 8.
Quadriceps femoris strength asymmetry at the time of return to sports participation after anterior cruciate ligament (ACL) reconstruction contributes to worse function and asymmetric landing patterns, but the impact on longitudinal outcomes is not known. This study determined if young athletes after ACL reconstruction with quadriceps femoris strength asymmetry at a return to sports clearance would demonstrate markers of knee cartilage degeneration 5 years later compared to those with symmetric quadriceps femoris strength at return to sports. Participants (n = 27) were enrolled at the time of medical clearance for sports participation (baseline testing) and followed for 5 years. At baseline, quadriceps femoris strength was measured bilaterally and a limb symmetry index was used to divide the cohort into two groups: return to sport clearance with high quadriceps femoris strength (RTS-HQ; limb symmetry index ≥ 90%) and return to sport clearance with low quadriceps femoris strength (RTS-LQ; limb symmetry index < 85%). At 5 years post-baseline, quantitative magnetic resonance imaging (T2 relaxation times (ms): involved knee medial/lateral femoral condyle and tibial plateau) data were collected. Group differences were evaluated with independent samples t tests. At 5 years post-return to sports, the RTS-LQ strength group (n = 14) demonstrated elevated T2 relaxation times at the anterior region of the lateral femoral condyle compared to the RTS-HQ strength group (n = 13). Clinical Significance: Just over 50% of this cohort was cleared for sports participation with involved limb quadriceps femoris strength deficits that may contribute to early markers of knee cartilage degeneration within the subsequent 5 years.
股四头肌力量在 ACL 重建后重返运动时的不对称性会导致功能更差和不对称的着陆模式，但对纵向结果的影响尚不清楚。本研究旨在确定在 ACL 重建后重返运动时股四头肌力量存在不对称性的年轻运动员与重返运动时股四头肌力量对称的运动员相比，5 年后是否会出现膝关节软骨退变的标志物。参与者（n=27）在接受运动医学 clearance 时（基线测试）入组，并随访 5 年。基线时，双侧测量股四头肌力量，并使用肢体对称性指数将队列分为两组：重返运动 clearance 时股四头肌力量高（RTS-HQ；肢体对称性指数≥90%）和重返运动 clearance 时股四头肌力量低（RTS-LQ；肢体对称性指数<85%）。在基线后 5 年，收集定量磁共振成像（T2 弛豫时间（ms）：受累膝关节内侧/外侧股骨髁和胫骨平台）数据。采用独立样本 t 检验评估组间差异。在重返运动后 5 年，RTS-LQ 力量组（n=14）的外侧股骨髁前区域的 T2 弛豫时间高于 RTS-HQ 力量组（n=13）。临床意义：超过 50%的队列在参与的肢体股四头肌力量缺陷下被清除，这可能会导致随后 5 年内膝关节软骨退变的早期标志物。
