School of Kinesiology, Western University, London, Ontario, Canada.
Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
J Orthop Res. 2024 Feb;42(2):349-359. doi: 10.1002/jor.25694. Epub 2023 Oct 8.
The purpose was to (1) compare the effect of a walking bout on femoral cartilage deformation between limbs with and without anterior cruciate ligament reconstruction (ACLR) and (2) examine the association between gait kinetics and the magnitude of cartilage deformation. A total of 30 individuals with primary unilateral ACLR completed this study [14 male, 16 female; age = 22.57 (3.78) years; body mass index (BMI) = 25.88 (5.68) kg/m ; time since ACLR = 61.00 (16.43) months]. Overground walking biomechanics were assessed on day 1, and a 30-min walking bout or 30-min resting bout (control) were completed on days 2 and 3 (counterbalanced order). Femoral cartilage thickness was measured using ultrasound before, immediately following, and 30-min following each intervention. Linear mixed effects models compared the effect of walking on cartilage thickness between the ACLR and contralateral limbs after adjusting for sex, BMI, speed, and the number of steps. Stepwise regression examined the association between the external knee flexion and adduction moments and cartilage deformation following walking. There was a significant limb × time interaction for medial cartilage thickness. Post hoc analyses indicated that cartilage thickness decreased immediately following walking in the contralateral but not ACLR limb. Main effects of limb were observed for medial, central, and lateral cartilage thickness indicating thicker cartilage in the ACLR compared with contralateral limb. A higher knee adduction moment was associated with greater cartilage deformation in the ACLR limb. Femoral cartilage in the ACLR limb exhibited a less dynamic response to walking than the uninvolved limb, which may be due to habitual underloading during gait.
(1) 比较有无前交叉韧带重建 (ACLR) 的肢体在单次步行运动后对股骨软骨变形的影响；(2) 研究步态动力学与软骨变形程度之间的关系。共有 30 名初次单侧 ACLR 的个体完成了本研究[男性 14 名，女性 16 名；年龄=22.57（3.78）岁；体重指数 (BMI)=25.88（5.68）kg/m；ACL 重建后时间=61.00（16.43）个月]。在第 1 天评估了地面行走生物力学，在第 2 天和第 3 天（平衡顺序）完成了 30 分钟步行运动或 30 分钟休息运动（对照）。在每次干预之前、之后即刻和之后 30 分钟使用超声测量股骨软骨厚度。线性混合效应模型在调整性别、BMI、速度和步数后，比较了 ACLR 和对侧肢体在行走运动后对软骨厚度的影响。逐步回归分析了行走后膝关节外屈和内收力矩与软骨变形之间的关系。内侧软骨厚度存在明显的肢体×时间交互作用。事后分析表明，对侧肢体在步行后即刻软骨厚度减小，但 ACLR 肢体没有。内侧、中央和外侧软骨厚度均存在肢体的主要作用，表明 ACLR 肢体的软骨比对侧肢体厚。ACLR 肢体的膝关节内收力矩越大，软骨变形越大。ACLR 肢体的股骨软骨对行走的动态反应小于未受累肢体，这可能是由于步态过程中习惯性的负重不足。
