Pereira Carla S, Klauznicer Jasenko, Maree Dustin, McAuliffe Sean, Farooq Abdulaziz, Whiteley Rod, Finni Taija
Rehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.
Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Front Rehabil Sci. 2023 Oct 19;4:1283635. doi: 10.3389/fresc.2023.1283635. eCollection 2023.
Anterior cruciate ligament (ACL) injuries cause knee instability, knee pain, weight-bearing adjustments, and functional deficits but their association to patellar tendon quality is unknown. Our purpose was to investigate quadriceps strength, patellar tendon quality, relative load exposure, perceived knee stability, knee pain, extension angle, and time from ACL injury; in addition to examining their relative associations.
Injured and uninjured legs of 81 male athletes of different sports with a unilateral ACL injury (18-45 years) were examined. Participants reported location and intensity of knee pain and their perceived stability using a numerical rating scale (NRS 0-10). Strength was tested with an isokinetic device. Tendon quality was measured using ultrasound tissue characterization. Means ± standard deviation (SD) of perceived knee stability, knee extension angle, knee pain, isokinetic quadriceps strength in relation to body mass, proportion of echo-types (I-IV), tendon volume, and number of days from ACL injury to assessment are reported. Values of effect sizes (ES) and correlations () were calculated.
ACL injured leg demonstrated reduced reported knee stability (6.3 ± 2.5), decreased knee extension angle (-0.7 ± 3.1° vs. -2.7 ± 2.2°; ES = 0.7; < 0.001), greater knee pain (NRS 3.1 ± 2.2 vs. 0.0 ± 0.1; ES = 2.0; < 0.001), and 22% lower quadriceps strength (228.0 ± 65.0 vs. 291.2 ± 52.9 Nm/kg: ES = 1.2; < 0.001) as compared to the uninjured leg. However, patellar tendons in both legs displayed similar quality. Quadriceps strength was associated with stability (= -0.54; < 0.001), pain (= -0.47; < 0.001), extension angle (= -0.39; < 0.001), and relative load exposure (= -0.34; < 0.004). Echo-types distribution was beneficially associated with time from ACL injury ( range: -0.20/ -0.32; < 0.05).
ACL injured athletes displayed knee pain, extension deficit, and weaker quadriceps in the injured leg. While there were no differences in patellar tendon quality between legs, longer time from ACL injury showed better tendon quality.
前交叉韧带（ACL）损伤会导致膝关节不稳定、膝关节疼痛、负重调整和功能缺陷，但其与髌腱质量的关联尚不清楚。我们的目的是研究股四头肌力量、髌腱质量、相对负荷暴露、感知到的膝关节稳定性、膝关节疼痛、伸展角度以及自ACL损伤后的时间；此外还将研究它们之间的相对关联。
对81名单侧ACL损伤（年龄18 - 45岁）的不同运动项目男性运动员的受伤腿和未受伤腿进行检查。参与者使用数字评分量表（NRS 0 - 10）报告膝关节疼痛的位置和强度以及他们感知到的稳定性。使用等速装置测试力量。使用超声组织特征分析测量腱质量。报告了感知到的膝关节稳定性、膝关节伸展角度、膝关节疼痛、与体重相关的等速股四头肌力量、回声类型（I - IV）比例、腱体积以及从ACL损伤到评估的天数的平均值±标准差（SD）。计算了效应大小（ES）和相关性（）值。
与未受伤腿相比，ACL损伤腿的报告膝关节稳定性降低（6.3±2.5），膝关节伸展角度减小（-0.7±3.1°对-2.7±2.2°；ES = 0.7；<0.001），膝关节疼痛更严重（NRS 3.1±2.2对0.0±0.1；ES = 2.0；<0.001），股四头肌力量低22%（228.0±65.0对291.2±52.9 Nm/kg：ES = 1.2；<0.001）。然而，双腿的髌腱质量相似。股四头肌力量与稳定性（= -0.54；<0.001）、疼痛（= -0.47；<0.001）、伸展角度（= -0.39；<0.001）和相对负荷暴露（= -0.34；<0.004）相关。回声类型分布与自ACL损伤后的时间呈有益关联（范围：-0.20 / -0.32；<0.05）。
ACL损伤的运动员受伤腿表现出膝关节疼痛、伸展不足和股四头肌较弱。虽然双腿之间髌腱质量没有差异，但自ACL损伤后的时间越长，腱质量越好。
