膝关节力量的 4 个月时的对称性与前交叉韧带重建后重返运动的标准和比率相关。
Knee strength symmetry at 4 months is associated with criteria and rates of return to sport after anterior cruciate ligament reconstruction.
机构信息
Service de Médecine Physique et de Réadaptation, Service de Médecine du Sport, CHU de Caen Normandie, Normandie Univ, UNICAEN, INSERM, COMETE, GIP CYCERON, Caen 14000, France.
Service de Médecine Physique et de Réadaptation, Service de Médecine du Sport, CHU de Caen Normandie, Caen 14000, France.
出版信息
Ann Phys Rehabil Med. 2022 Jun;65(4):101646. doi: 10.1016/j.rehab.2022.101646. Epub 2022 Apr 30.
BACKGROUND
Strength limb symmetry index (LSI) is a useful criterion to help in return-to-sport performance (RTP) after anterior cruciate ligament reconstruction (ACLR).
OBJECTIVES
We aimed to assess whether knee extensor and flexor LSI values at 4 months after ACLR are associated with those recommended at 8 months after ACLR for RTP (80%, 85% and 90%) and with successful RTP after 2 years.
METHODS
This was prospective cohort study of 113 participants who underwent primary ACLR. Personal factors such as demographic and sport information, injury and surgery characteristics were collected at 6 weeks after surgery. Isokinetic strength LSI (60°/s) was calculated at 4 months (LSI[4 m]) and 8 months (LSI[8 m]) for knee extensors (Q-LSI) and flexors (H-LSI). Participants were followed at 2 years after ACLR to determine their self-reported RTP. Multiple linear regression analysis was used to determine associations between personal factors and LSI at 4 and 8 months. Associations between passing the optimal cut-off thresholds and RTP were tested with chi-square tests and odds ratios (ORs) with effect sizes (ES).
RESULTS
Among the 113 participants (mean age 25.2 [SD 9.7] years; 42% females), extended tourniquet time and lower level of pre-injury sport were associated with lower Q-LSI[4m] and H-LSI[4m]. Bone-patellar tendon-bone graft was associated with lower Q-LSI[4m] and Q-LSI[8m], and older age was associated with lower Q-LSI[4m]. For knee extensors, Q-LSI[4m] >59% was associated with Q-LSI[8m] >80% (OR= 31.50, p < 0.001, large ES) and increased odds of successful RTP (60% vs 31%, OR= 3.45, p = 0.003, medium ES). For knee flexors, H-LSI[4m] >72% was associated with H-LSI[8m] >90% (OR= 6.03, p < 0.001, large ES) and increased odds of successful RTP (53% vs 23%, OR= 3.76, p = 0.013, small-to-medium ES).
CONCLUSIONS
After primary ACLR, 4-month post-operative strength symmetry was negatively associated with age, pre-injury sport and tourniquet time and bone-patellar tendon-bone graft. Four-month post-operative LSI was associated with 8-month post-operative LSI, and Q-LSI[4m] >59% or H-LSI[4m] >72% was associated with increased RTP rates after 2 years.
CLINICALTRIALS
GOV: NCT04071912.
背景
强度肢体对称指数（LSI）是帮助评估前交叉韧带重建（ACLR）后重返运动表现（RTP）的有用标准。
目的
我们旨在评估 ACLR 后 4 个月时膝关节伸肌和屈肌的 LSI 值是否与 ACLR 后 8 个月时推荐用于 RTP（80%、85%和 90%）的 LSI 值以及 2 年后成功 RTP 相关。
方法
这是一项对 113 名接受初次 ACLR 的参与者进行的前瞻性队列研究。术后 6 周收集个人因素，如人口统计学和运动信息、损伤和手术特征。在 4 个月（LSI[4m]）和 8 个月（LSI[8m]）时计算膝关节伸肌（Q-LSI）和屈肌（H-LSI）的等速力量 LSI（60°/s）。在 ACLR 后 2 年对参与者进行随访，以确定他们的自我报告的 RTP。采用多元线性回归分析确定个人因素与 4 个月和 8 个月时的 LSI 之间的关联。使用卡方检验和优势比（OR）和效果大小（ES）测试通过最佳截止阈值的概率与 RTP 之间的关联。
结果
在 113 名参与者中（平均年龄 25.2[9.7]岁；42%为女性），延长止血带时间和较低的术前运动水平与较低的 Q-LSI[4m]和 H-LSI[4m]相关。骨-髌腱-骨移植物与较低的 Q-LSI[4m]和 Q-LSI[8m]相关，年龄较大与较低的 Q-LSI[4m]相关。对于膝关节伸肌，Q-LSI[4m]>59%与 Q-LSI[8m]>80%相关（OR=31.50，p<0.001，大 ES），并且成功 RTP 的几率增加（60%比 31%，OR=3.45，p=0.003，中 ES）。对于膝关节屈肌，H-LSI[4m]>72%与 H-LSI[8m]>90%相关（OR=6.03，p<0.001，大 ES），并且成功 RTP 的几率增加（53%比 23%，OR=3.76，p=0.013，小-中 ES）。
结论
初次 ACLR 后，术后 4 个月的力量对称性与年龄、术前运动水平和止血带时间以及骨-髌腱-骨移植物有关。术后 4 个月的 LSI 与术后 8 个月的 LSI 相关，Q-LSI[4m]>59%或 H-LSI[4m]>72%与 2 年后 RTP 率增加相关。
临床试验
政府：NCT04071912。
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