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前交叉韧带重建术后的继发损伤预防:骨盆下降与动态膝关节外翻的关系。

Prevention of Secondary Injury after Anterior Cruciate Ligament Reconstruction: Relationship between Pelvic-Drop and Dynamic Knee Valgus.

机构信息

Member of the Medical-Scientific Multidisciplinary Commission, Italian Football Doctors Association-L.A.M.I.CA., 04023 Formia, Italy.

Department of Physiotherapy, Faculty of Allied Medical Science, Middle East University, Amman 11622, Jordan.

出版信息

Int J Environ Res Public Health. 2023 Feb 9;20(4):3063. doi: 10.3390/ijerph20043063.


DOI:10.3390/ijerph20043063
PMID:36833752
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9958946/
Abstract

(1) Background: Optimal neuromuscular, Lumbo-Pelvic-Hip Complex, and lower extremity control are associated with decreased risk factors for secondary anterior cruciate ligament (ACL) injury. This study aimed to analyze any asymmetries and malalignments in the Lumbo-Pelvic-Hip Complex and the lower limbs at 6 months after ACL reconstruction (ACLR). (2) Methods: We conducted an exploratory retrospective observational single-center study in patients during the outpatient postoperative rehabilitation program at ICOT (Latina, Italy). From January 2014 to June 2020, 181 patients were recruited, but only 100 patients (86 male 28 ± 0.6 years, 178 ± 0.5 height; 14 female 24 ± 2.0 years, 178 ± 3.0 height) were eligible for the inclusion criteria and studied 6 months after ACL reconstruction surgery. (3) Statistical analysis: Student's -tests and Pearson's product-moment correlation coefficient were used to determine significant differences between affected and non-affected limbs and variables' association. (4) Results: The study shows a decrease in neuromuscular control of the Lumbo-Pelvic-Hip Complex and dynamic adaptive valgus of the knee at 6 months after ACLR (mean difference between pathological and healthy limb of dynamic adaptive valgus was -10.11 ± 8.19° 95% CI -14.84 to -9.34; mean value was 16.3 ± 6.8° 95% CI 14.04 to 18.55 for healthy limb and 4.2 ± 3.1° 95% CI 3.15 to 5.21 for pathological limb, < 0.0001). The results also showed a relationship between dynamic adaptive valgus and contralateral pelvic drop (r = 0.78, 95% CI 0.62 to 0.88, magnitude of correlation very large). (5) Conclusions: The analysis showed an associative correlation between decreased postural control of the pelvic girdle and dynamic adaptive valgus of the knee in 38% of patients; this study highlights the usefulness of the Single-Leg Squat Test (SLST) as a clinical/functional assessment to evaluate the rehabilitation process and as a preventive tool to reduce the risk of second ACL injuries during the return to sport.

摘要

(1) 背景:最佳的神经肌肉、腰骶骨盆髋复合体和下肢控制与降低二次前交叉韧带(ACL)损伤的风险因素相关。本研究旨在分析 ACL 重建(ACLR)后 6 个月时腰骶骨盆髋复合体和下肢的任何不对称和排列不齐。 (2) 方法:我们在 ICOT(意大利拉蒂纳)的门诊术后康复计划中对患者进行了一项探索性回顾性观察性单中心研究。2014 年 1 月至 2020 年 6 月,共招募了 181 名患者,但只有 100 名患者(86 名男性,28 ± 0.6 岁,178 ± 0.5 身高;14 名女性,24 ± 2.0 岁,178 ± 3.0 身高)符合纳入标准,并在 ACLR 后 6 个月进行了研究。 (3) 统计分析:使用学生 t 检验和 Pearson 积差相关系数来确定患侧和非患侧之间以及变量之间的显著差异。 (4) 结果:研究表明,在 ACLR 后 6 个月时,腰骶骨盆髋复合体的神经肌肉控制和膝关节动态适应性外翻能力下降(患侧和健侧动态适应性外翻的平均差值为-10.11 ± 8.19°95%CI-14.84 至-9.34;健侧平均值为 16.3 ± 6.8°95%CI14.04 至 18.55,患侧为 4.2 ± 3.1°95%CI3.15 至 5.21,<0.0001)。结果还表明,动态适应性外翻与对侧骨盆下降之间存在关系(r = 0.78,95%CI0.62 至 0.88,相关性大小为非常大)。 (5) 结论:分析表明,在 38%的患者中,骨盆带姿势控制下降与膝关节动态适应性外翻之间存在关联;本研究强调了单腿深蹲测试(SLST)作为一种临床/功能评估的有用性,可用于评估康复过程,并作为一种预防工具,以降低重返运动时二次 ACL 损伤的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9958946/df3cdf8429c0/ijerph-20-03063-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9958946/d757aecf3c28/ijerph-20-03063-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9958946/4356c8e6d7d6/ijerph-20-03063-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9958946/df3cdf8429c0/ijerph-20-03063-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9958946/d757aecf3c28/ijerph-20-03063-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9958946/4356c8e6d7d6/ijerph-20-03063-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbc3/9958946/df3cdf8429c0/ijerph-20-03063-g003.jpg

相似文献

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Prevention of Secondary Injury after Anterior Cruciate Ligament Reconstruction: Relationship between Pelvic-Drop and Dynamic Knee Valgus.

Int J Environ Res Public Health. 2023-2-9

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[10]
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引用本文的文献

[1]
The effects of training intervention on the prevention of knee joint injuries: a systematic review and meta-analysis.

Front Physiol. 2025-2-24

[2]
Management of Lumbar Disc Herniation With Nerve Compression in a 21-Year-Old Male: A Case Report Exploring Multifactorial Causes of Disc Herniation.

Cureus. 2025-1-24

[3]
The acute effect of verbal instructions on performance and landing when dropping from different heights: the ground reaction force-time profile of drop vertical jumps in female volleyball athletes.

Front Sports Act Living. 2024-10-24

本文引用的文献

[1]
Effect of lumbopelvic control on landing mechanics and lower extremity muscles' activities in female professional athletes: implications for injury prevention.

BMC Sports Sci Med Rehabil. 2021-8-29

[2]
Determining Trendelenburg test validity and reliability using 3-dimensional motion analysis and muscle dynamometry.

Chiropr Man Therap. 2020-10-19

[3]
Single-Leg Squat After Anterior Cruciate Ligament Reconstruction: An Analysis of the Knee Valgus Angle at 6 and 12 Months.

Orthop J Sports Med. 2020-8-26

[4]
Management of Anterior Cruciate Ligament Injury: What's In and What's Out?

Indian J Orthop. 2017

[5]
Measurement properties of visual rating of postural orientation errors of the lower extremity - A systematic review and meta-analysis.

Phys Ther Sport. 2017-9

[6]
Restricted Hip Rotation Is Correlated With an Increased Risk for Anterior Cruciate Ligament Injury.

Arthroscopy. 2017-2

[7]
A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.

J Chiropr Med. 2016-6

[8]
Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity.

Arthroscopy. 2016-8

[9]
The relationship of foot and ankle mobility to the frontal plane projection angle in asymptomatic adults.

J Foot Ankle Res. 2016-1-25

[10]
Current Trends in Anterior Cruciate Ligament Reconstruction: A Review.

Cureus. 2015-11-13

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