Zhang Ling, Wang Shao-Bai, Fan Shuai, Ye Jiling, Cai Bin
Department of Rehabilitation Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 500th Quxi Road, Shanghai, 200010, China.
Key Laboratory of Exercise and Health Science, Ministry of Education, Shanghai University of Sport, Shanghai, China.
Int Orthop. 2022 Apr;46(4):837-843. doi: 10.1007/s00264-022-05302-7. Epub 2022 Jan 8.
The purpose of this study is to evaluate the difference of patellofemoral kinematics between weightbearing and non-weightbearing conditions in the arthrofibrotic knee after anterior cruciate ligament (ACL) reconstruction.
Twenty patients with arthrofibrosis after ACL reconstruction were included in the study. Computed tomography scanner and dual fluoroscopic imaging techniques were used to compare patellofemoral kinematics of the affected knee between weightbearing knee flexion and non-weightbearing knee flexion. In both positions, patellofemoral kinematics in six degrees-of-freedom (6 DOF) were measured respectively.
The patellar lateral tilt angle (p = 0.007) and medial patellar translation (p = 0.043) under the weightbearing condition were significantly decreased compared to the non-weightbearing task between 5° and 15° of knee flexion. The lateral patellar translation during a non-weightbearing task was significantly decreased between 60° and 75° of knee flexion (p = 0.005), and the inferior patellar translation under the weightbearing condition was significantly increased between 45° and 75° of knee flexion (p = 0.040).
These results indicate that patellofemoral kinematics during non-weightbearing positions do not sufficiently represent the patellar tracking during functional weightbearing activities. Our findings of this study establish the clinical relevance and significance of assessing the patellofemoral kinematics under the weightbearing condition when evaluating patients with arthrofibrosis after ACL reconstruction.
Trial registration number: ChiCTR1900025977.
本研究旨在评估前交叉韧带（ACL）重建术后关节纤维化膝关节在负重和非负重状态下髌股关节运动学的差异。
本研究纳入了20例ACL重建术后关节纤维化患者。采用计算机断层扫描和双荧光透视成像技术，比较患侧膝关节在负重屈膝和非负重屈膝时的髌股关节运动学。在两种体位下，分别测量髌股关节六个自由度（6DOF）的运动学参数。
在屈膝5°至15°时，负重状态下的髌骨外侧倾斜角（p = 0.007）和髌骨内侧移位（p = 0.043）与非负重状态相比显著降低。在屈膝60°至75°时，非负重状态下的髌骨外侧移位显著降低（p = 0.005），在屈膝45°至75°时，负重状态下的髌骨下移显著增加（p = 0.040）。
这些结果表明，非负重状态下的髌股关节运动学不能充分代表功能性负重活动时的髌骨轨迹。本研究结果确立了在评估ACL重建术后关节纤维化患者时，评估负重状态下髌股关节运动学的临床相关性和意义。
试验注册号：ChiCTR1900025977。
