Department of Medicine Dentistry and Health Sciences, Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, VIC, Australia.
School of Allied Health Sciences, Griffith University, Gold Coast, Australia.
Knee Surg Sports Traumatol Arthrosc. 2022 Jun;30(6):1949-1957. doi: 10.1007/s00167-021-06853-9. Epub 2022 Jan 7.
Quadriceps strength deficits following anterior cruciate ligament reconstruction (ACLR) are linked to altered lower extremity biomechanics, tibiofemoral joint (TFJ) space narrowing and cartilage composition changes. It is unknown, however, if quadriceps strength is associated with cartilage volume in the early years following ACLR prior to the onset of posttraumatic osteoarthritis (OA) development. The purpose of this cross-sectional study was to examine the relationship between quadriceps muscle strength (peak and across the functional range of knee flexion) and cartilage volume at ~ 2 years following ACLR and determine the influence of concomitant meniscal pathology.
The involved limb of 51 ACLR participants (31 isolated ACLR; 20 combined meniscal pathology) aged 18-40 years were tested at 2.4 ± 0.4 years post-surgery. Isokinetic knee extension torque generated in 10° intervals between 60° and 10° knee flexion (i.e. 60°-50°, 50°-40°, 40°-30°, 30°-20°, 20°-10°) together with peak extension torque were measured. Tibial and patellar cartilage volumes were measured using magnetic resonance imaging (MRI). The relationships between peak and angle-specific knee extension torque and MRI-derived cartilage volumes were evaluated using multiple linear regression.
In ACLR participants with and without meniscal pathology, higher knee extension torques at 60°-50° and 50°-40° knee flexion were negatively associated with medial tibial cartilage volume (p < 0.05). No significant associations were identified between peak concentric or angle-specific knee extension torques and patellar cartilage volume.
Higher quadriceps strength at knee flexion angles of 60°-40° was associated with lower cartilage volume on the medial tibia ~ 2 years following ACLR with and without concomitant meniscal injury. Regaining quadriceps strength across important functional ranges of knee flexion after ACLR may reduce the likelihood of developing early TFJ cartilage degenerative changes.
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前交叉韧带重建（ACLR）后股四头肌力量不足与下肢生物力学改变、胫股关节（TFJ）空间变窄和软骨成分变化有关。然而，在创伤后骨关节炎（OA）发展之前，ACL 重建后早期是否存在股四头肌力量与软骨体积相关，目前尚不清楚。本横断面研究的目的是探讨 ACLR 后约 2 年股四头肌力量（峰值和膝关节屈伸功能范围内）与软骨体积之间的关系，并确定合并半月板病变的影响。
51 名 ACLR 参与者（31 名单纯 ACLR；20 名合并半月板病变）的受累肢体在手术后 2.4±0.4 年进行测试。在 60°至 10°膝关节屈曲的 10°间隔内测量等速膝关节伸展扭矩（即 60°-50°、50°-40°、40°-30°、30°-20°、20°-10°），同时测量峰值伸展扭矩。使用磁共振成像（MRI）测量胫骨和髌骨软骨体积。使用多元线性回归评估峰值和角度特异性膝关节伸展扭矩与 MRI 衍生软骨体积之间的关系。
在有和没有半月板病变的 ACLR 参与者中，膝关节 60°-50°和 50°-40°屈曲时较高的膝关节伸展扭矩与内侧胫骨软骨体积呈负相关（p<0.05）。在峰值向心或角度特异性膝关节伸展扭矩与髌骨软骨体积之间未发现显著相关性。
ACL 重建后 2 年，膝关节 60°-40°范围内股四头肌力量较高与内侧胫骨软骨体积较低相关，无论是否伴有半月板损伤。ACL 重建后在重要的膝关节屈伸功能范围内恢复股四头肌力量可能会降低早期 TFJ 软骨退行性变化的可能性。
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