Skvortsov Dmitry, Altukhova Alyona, Kaurkin Sergey, Akhpashev Alexander
Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Orekhoviy Bulvar 28, Moscow 115682, Russia.
Rehabilitation Department, Pirogov Russian National Research Medical University RNRMU, Ul. Ostrovitianova 1, Moscow 117997, Russia.
J Clin Med. 2023 Jul 20;12(14):4803. doi: 10.3390/jcm12144803.
There is still controversy over the criteria for acute ACL tear. In this paper, knee joint function and walking were considered possible ones.
The study included 21 subjects with acute ACL tear and 20 healthy volunteers as a control group. Biomechanical gait analysis was performed using the inertial sensor system including EMG recording. All subjects (but for controls) were divided into two groups: Group 1-"up to 4 weeks" and Group 2-"from 4 weeks to 3 months".
Temporal gait parameters in subjects from Group 1 demonstrate the asymmetry of 4% and more in terms of the gait cycle with a decrease in the affected limb, and are within normal range in Group 2. The amplitudes at the hip and knee joints in the affected limb are reduced which is especially pronounced in Group 1 (2-4 and 6-10 degrees, respectively). The affected knee joint shows a decrease in the range of motion by up to 5 degrees in the first half of the stance phase and flexion by less than 40 degrees in the swing phase. The tibialis anterior and quadriceps femoris muscle function is decreased in the affected limb only in Group 1 (72% and 78% from normal, respectively).
The severity of the condition after an ACL tear is largely determined by functional changes. The time factor is of secondary importance.
急性前交叉韧带撕裂的诊断标准仍存在争议。本文认为膝关节功能和行走可能是相关诊断标准。
本研究纳入21例急性前交叉韧带撕裂患者,并选取20名健康志愿者作为对照组。使用包括肌电图记录的惯性传感器系统进行生物力学步态分析。所有受试者(对照组除外)分为两组:第1组——“4周以内”,第2组——“4周以上至3个月”。
第1组受试者的步态时间参数显示,患侧肢体在步态周期方面的不对称率达到4%及以上,且患侧肢体存在下降情况,而第2组则在正常范围内。患侧肢体髋关节和膝关节的活动幅度减小,这在第1组中尤为明显(分别为2 - 4度和6 - 10度)。患侧膝关节在站立相上半程的活动范围减少多达5度,在摆动相的屈曲角度小于40度。仅在第1组中,患侧肢体的胫骨前肌和股四头肌功能下降(分别为正常水平的72%和78%)。
前交叉韧带撕裂后病情的严重程度在很大程度上由功能变化决定。时间因素是次要的。