Sahoo P K, Sahu M M
Department of Physical Medicine and Rehabilitation, Swami Vivekanand National Institute of Rehabilitation Training and Research, Cuttack, India.
Department of Physiotherapy, Swami Vivekanand National Institute of Rehabilitation Training and Research, Cuttack, India.
Malays Orthop J. 2023 Mar;17(1):133-141. doi: 10.5704/MOJ.2303.016.
Harvesting peroneus longus for ACL reconstruction is thought to create ankle instability which could add to postural instability from an ACL injury. This apprehension prevents its use as a graft of primary choice for many surgeons. To date, there is no evidence available describing changes in postural control after its use in ACL reconstruction. The purpose of the study was to analyse the changes in postural control in the form of static and dynamic body balance after ACL reconstruction with Peroneus Longus Tendon Graft and compare it with the unaffected limb at different time intervals.
Thirty-one participants with ACL injury were selected and subjected to an assessment of static and dynamic balance before and after ACL reconstruction using the HUMAC balance system. Outcome measures for Centre of Pressure (COP) assessment were average velocity, path length, stability score, and time on target. Comparison of scores was done pre-operatively as well as at three- and six-months post-reconstruction with Peroneus longus tendon graft.
Static balance of the affected limb showed significant improvement with a decrease in average velocity (F=4.522, p=0.026), path length (F=4.592: p=0.024) and improvement of stability score (F=8.283, p=0.001). Dynamic balance measured by the time on the target variable also showed significant improvement at six-month follow-up (F=10.497: p=0.000). There was no significant difference between the affected and non-affected limb when compared at the different time intervals.
The static and dynamic balance, which is impaired after ACL injury, improves with ACL reconstruction with PLT autologous graft. Hence PLTG can be safely used as a graft for ACL reconstruction without affecting postural control and body balance.
人们认为，采用腓骨长肌进行前交叉韧带重建会导致踝关节不稳定，这可能会加重前交叉韧带损伤引起的姿势不稳。这种担忧使得许多外科医生不将其作为首选移植物。迄今为止，尚无证据描述其用于前交叉韧带重建后姿势控制的变化。本研究的目的是分析采用腓骨长肌腱移植物进行前交叉韧带重建后，以静态和动态身体平衡形式表现的姿势控制变化，并在不同时间间隔将其与未受影响的肢体进行比较。
选取31名前交叉韧带损伤患者，使用HUMAC平衡系统在重建前和重建后对其进行静态和动态平衡评估。压力中心（COP）评估的结果指标包括平均速度、路径长度、稳定性评分和目标停留时间。在术前以及重建后三个月和六个月时，对采用腓骨长肌腱移植物的患者的评分进行比较。
患侧肢体的静态平衡有显著改善，平均速度降低（F = 4.522，p = 0.026），路径长度缩短（F = 4.592，p = 0.024），稳定性评分提高（F = 8.283，p = 0.001）。以目标停留时间变量衡量的动态平衡在六个月随访时也有显著改善（F = 10.497，p = 0.000）。在不同时间间隔进行比较时，患侧和未患侧肢体之间没有显著差异。
前交叉韧带损伤后受损的静态和动态平衡，通过自体腓骨长肌腱移植物进行前交叉韧带重建后得到改善。因此，腓骨长肌腱移植物可安全地用作前交叉韧带重建的移植物，而不会影响姿势控制和身体平衡。
