Dean Robert S, DePhillipo Nicholas N, Kiely Michael T, Schwery Nicole A, Monson Jill K, LaPrade Robert F
Twin City Orthopedics.
Twin City Orthopedics; Oslo Sports Trauma Research Center.
Int J Sports Phys Ther. 2022 Jun 2;17(4):628-635. doi: 10.26603/001c.35704. eCollection 2022.
Few existing studies have examined the relationship between lower extremity bone length and quadriceps strength.
PURPOSE/HYPOTHESIS: To evaluate the relationship between lower extremity, tibia and femur lengths, and isometric quadriceps strength in patients undergoing knee surgery. The null hypothesis was that there would be no correlation between lower extremity length and isometric quadriceps strength.
Cross-sectional study.
Patients with full-length weightbearing radiographs that underwent isometric quadriceps strength testing after knee surgery were included. Using full-length weightbearing radiographs, limb length was measured from the ASIS to the medial malleolus; femur length was measured from the center of the femoral head to the joint line; tibia length was measured from the center of the plateau to the center of the plafond. Isometric quadriceps strength was measured using an isokinetic dynamometer. Pearson's correlation coefficient was used to report the correlation between radiographic limb length measurements. A Bonferroni correction was utilized to reduce the probability of a Type 1 error.
Forty patients (26 males, 14 females) with an average age of 25.8 years were included. The average limb, femur, and tibia lengths were not significantly different between operative and non-operative limbs (p>0.05). At an average of 5.8±2.5 months postoperatively, the peak torque (156.6 vs. 225.1 Nm), average peak torque (151.6 vs. 216.7 Nm), and peak torque to bodyweight (2.01 vs 2.89 Nm/Kg) were significantly greater in the non-surgical limb (p<0.01). Among ligament reconstructions there was a significant negative correlation between both limb length and strength deficit (r= -0.47, p=0.03) and femur length and strength deficit (r= -0.51, p=0.02). The average strength deficit was 29.6% among the entire study population; the average strength deficit was 37.7% among knee ligament reconstructions. For the non-surgical limb, femur length was significantly correlated with peak torque (r = 0.43, = 0.048).
Femur length was significantly correlated with the isometric quadriceps peak torque for non-surgical limbs. Additionally, femur length and limb length were found to be negatively correlated with quadriceps strength deficit among ligament reconstruction patients. A combination of morphological features and objective performance metrics should be considered when developing individualized rehabilitation and strength programs.
现有研究很少探讨下肢骨长度与股四头肌力量之间的关系。
目的/假设：评估接受膝关节手术患者的下肢、胫骨和股骨长度与股四头肌等长力量之间的关系。原假设是下肢长度与股四头肌等长力量之间无相关性。
横断面研究。
纳入术后接受股四头肌等长力量测试且有全长负重X线片的患者。利用全长负重X线片，从髂前上棘至内踝测量肢体长度；从股骨头中心至关节线测量股骨长度；从平台中心至髁间隆突中心测量胫骨长度。使用等速测力计测量股四头肌等长力量。采用Pearson相关系数报告X线肢体长度测量值之间的相关性。采用Bonferroni校正以降低I型错误的概率。
纳入40例患者（26例男性，14例女性），平均年龄25.8岁。手术侧与非手术侧肢体的平均肢体、股骨和胫骨长度无显著差异（p>0.05）。术后平均5.8±2.5个月时，非手术侧肢体的峰值扭矩（156.6对225.1 Nm）、平均峰值扭矩（151.6对216.7 Nm）以及峰值扭矩与体重之比（2.01对2.89 Nm/Kg）显著更高（p<0.01）。在韧带重建患者中，肢体长度与力量 deficit之间以及股骨长度与力量 deficit之间均存在显著负相关（r = -0.47，p = 0.03；r = -0.51，p = 0.02）。整个研究人群的平均力量 deficit为29.6%；膝关节韧带重建患者的平均力量 deficit为37.7%。对于非手术侧肢体，股骨长度与峰值扭矩显著相关（r = 0.43，p = 0.048）。
股骨长度与非手术侧肢体的股四头肌等长峰值扭矩显著相关。此外，在韧带重建患者中，股骨长度和肢体长度与股四头肌力量 deficit呈负相关。在制定个性化康复和力量训练计划时，应综合考虑形态学特征和客观表现指标。
