Jiang Hai, Zhang Lei, Zhang Rui-Ying, Zheng Qiu-Jian, Li Meng-Yuan
Department of Orthopedic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, NO. 106, Zhongshan 2nd Road, 510000, Guangzhou, China.
Department of Rehabilitation, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, NO. 106, Zhongshan 2nd Road, 510000, Guangzhou, China.
BMC Musculoskelet Disord. 2021 May 18;22(1):452. doi: 10.1186/s12891-021-04350-1.
Strength recovery of injured knee is an important parameter for patients who want to return to sport after anterior cruciate ligament reconstruction (ACLR). Comparison of muscle strength between anatomical and non-anatomical ACLR has not been reported.
To evaluate the difference between anatomical and non-anatomical single-bundle ACLR in hamstring and quadriceps strength and clinical outcomes.
Patients received unilateral primary single-bundle hamstring ACLR between January 2017 to January 2018 were recruited in this study. Patients were divided into anatomical reconstruction group (AR group) and non-anatomical reconstruction group (NAR group) according to femoral tunnel aperture position. The hamstring and quadriceps isokinetic strength including peak extension torque, peak flexion torque and H/Q ratio were measured at an angular velocity of 180°/s and 60°/s using an isokinetic dynamometer. The isometric extension and flexion torques were also measured. Hamstring and quadriceps strength were measured preoperatively and at 3, 6, and 12 months after surgery. Knee stability including Lachman test, pivot-shift test, and KT-1000 measurement and subjective knee function including International Knee Documentation Committee (IKDC) and Lysholm scores were evaluated during the follow-up.
Seventy-two patients with an average follow-up of 30.4 months (range, 24-35 months) were included in this study. Thirty-three were in AR group and 39 in NAR group. The peak knee flexion torque was significant higher in AR group at 180°/s and 60°/s (P < 0.05 for both velocity) at 6 months postoperatively and showed no difference between the two groups at 12 months postoperatively. The isometric knee extension torque was significant higher in AR group at 6 months postoperatively (P < 0.05) and showed no difference between the two groups at 12 months postoperatively. No significant differences between AR group and NAR group were found regarding knee stability and subjective knee function evaluations at follow-up.
Compared with non-anatomical ACLR, anatomical ACLR showed a better recovery of hamstring and quadriceps strength at 6 months postoperatively. However, the discrepancy on hamstring and quadriceps strength between the two groups vanished at 1 year postoperatively.
对于希望在前交叉韧带重建（ACLR）后恢复运动的患者而言，受伤膝关节的力量恢复是一个重要参数。解剖学与非解剖学ACLR之间的肌肉力量比较尚无报道。
评估解剖学与非解剖学单束ACLR在腘绳肌和股四头肌力量及临床结果方面的差异。
本研究纳入了2017年1月至2018年1月期间接受单侧初次单束腘绳肌ACLR的患者。根据股骨隧道开口位置将患者分为解剖重建组（AR组）和非解剖重建组（NAR组）。使用等速测力计在180°/秒和60°/秒的角速度下测量腘绳肌和股四头肌的等速力量，包括峰值伸展扭矩、峰值屈曲扭矩和H/Q比值。还测量了等长伸展和屈曲扭矩。在术前以及术后3、6和12个月测量腘绳肌和股四头肌力量。在随访期间评估膝关节稳定性，包括Lachman试验、轴移试验和KT-1000测量，以及主观膝关节功能，包括国际膝关节文献委员会（IKDC）和Lysholm评分。
本研究纳入了72例患者，平均随访30.4个月（范围24 - 35个月）。AR组33例，NAR组39例。术后6个月时，AR组在180°/秒和60°/秒时的膝关节峰值屈曲扭矩显著更高（两个速度下P均<0.05），术后12个月时两组之间无差异。术后6个月时，AR组的膝关节等长伸展扭矩显著更高（P<0.05），术后12个月时两组之间无差异。随访时，AR组和NAR组在膝关节稳定性和主观膝关节功能评估方面未发现显著差异。
与非解剖学ACLR相比，解剖学ACLR在术后6个月时腘绳肌和股四头肌力量恢复更好。然而，两组之间腘绳肌和股四头肌力量的差异在术后1年消失。
