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影响前交叉韧带股骨止点电凝术后治疗效果及本体感觉的因素。

Factors Influencing Treatment Outcome and Proprioception after Electrocoagulation of the Femoral Insertion of the Anterior Cruciate Ligament.

机构信息

Institute of Applied Mechanics, Poznan University of Technology, 60-965 Poznan, Poland.

Adult Spine Orthopaedics Department, Poznan University of Medical Sciences, 61-545 Poznan, Poland.

出版信息

Int J Environ Res Public Health. 2022 Oct 20;19(20):13569. doi: 10.3390/ijerph192013569.

Abstract

(1) Background: Studies have established that exercises shaping the sense of deep sensation are an important element of medical rehabilitation of patients after vaporization of the femoral insertion of the anterior cruciate ligament and affect the restoration of correct movement patterns, thus reducing the risk of injuries. The aim of this study was to determine the factors influencing the treatment outcome and deep-feeling function after applying a specific rehabilitation scheme 12 weeks after anterior cruciate ligament electrocoagulation surgery. (2) Methods: The study group consisted of 41 patients after partial rupture of the anterior cruciate ligament, who underwent electrocoagulation of the femoral cruciate ligament attachment and microfracture of the femoral attachment area. All patients were operated on by the same surgeon and then rehabilitated according to the same medical rehabilitation protocol. The anthropometric and clinical data were collected through an anterior drawer test, Lachman test, assessment of the range of movements in the knee joint, muscle strength test, Unterberger test and Lysholm questionnaire. The assessment was performed before the surgery, and then on days 7-10, after 6 and 12 weeks of rehabilitation treatment. (3) Results: Statistical improvement of the parameters was demonstrated by strength of the quadriceps and hamstrings muscle, the Unterberger test, and the Lysholm scale after surgery. A negative correlation was found between the Unterberger test and Lysholm scale at the end of the research period and it differed depending on the gender and the dominant limb. The Lysholm scale and muscle strength were independent of sex, dominant extremity and associated damage of the meniscus and cartilage. The Lysholm scale 6 weeks after surgery negatively correlated with BMI. (4) Conclusions: Stability of the knee joint and improvement of proprioception were demonstrated 12 weeks after treatment with an ACL electrocoagulation and rehabilitation regimen. The factors contributing to a better treatment outcome were greater muscle strength, less thigh asymmetry, better sense of depth, younger age and lower body weight.

摘要

(1) 背景:研究表明,深度感觉塑造练习是前交叉韧带股骨附着处汽化后患者医学康复的重要组成部分,可影响正确运动模式的恢复,从而降低受伤风险。本研究旨在确定在实施特定康复方案 12 周后影响前交叉韧带电凝术后治疗效果和深感觉功能的因素。(2) 方法:研究组由 41 例前交叉韧带部分撕裂患者组成,这些患者接受了股骨前交叉韧带附着处电凝和股骨附着区微骨折术。所有患者均由同一位外科医生进行手术,然后根据相同的医学康复方案进行康复。通过前抽屉试验、Lachman 试验、膝关节活动范围评估、肌肉力量测试、Unterberger 试验和 Lysholm 问卷收集人体测量学和临床数据。在手术前、手术后第 7-10 天、康复治疗后第 6 周和第 12 周进行评估。(3) 结果:手术后,股四头肌和腘绳肌力量、Unterberger 试验和 Lysholm 评分等参数的统计均有改善。在研究期末,Unterberger 试验与 Lysholm 评分呈负相关,且与性别和优势肢有关。Lysholm 评分和肌肉力量与性别、优势肢体以及半月板和软骨的相关损伤无关。术后 6 周的 Lysholm 评分与 BMI 呈负相关。(4) 结论:ACL 电凝和康复方案治疗 12 周后,膝关节稳定性和本体感觉改善。肌肉力量更大、大腿不对称程度更小、深度感觉更好、年龄更小、体重更轻的患者治疗效果更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/187f/9603566/26214c506ac6/ijerph-19-13569-g001.jpg

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