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在步态中出现膝关节伸展不足,并且在盘状外侧半月板撕裂的切除和修复后仍存在膝关节伸肌无力。

Knee extension deficit during gait and knee extensor weakness persisting after saucerization and repair of discoid lateral meniscus tears.

机构信息

Division of Rehabilitation, Kurume University Medical Center, Kurume, Japan; Kurume University, School of Medicine Graduate School, Kurume, Japan.

Department of Orthopaedic Surgery, Kurume University Medical Center, Kurume, Japan.

出版信息

Knee. 2024 Mar;47:171-178. doi: 10.1016/j.knee.2023.12.008. Epub 2024 Feb 23.

Abstract

BACKGROUND

Physical function and knee kinematics recovery after discoid lateral meniscus (DLM) tear surgery are essential for a better prognosis. However, these alterations remain unclear. Therefore, this study aimed to investigate changes in physical function and knee kinematics following saucerization and DLM tear repair.

METHODS

We enrolled 16 patients who underwent saucerization and DLM tear repair. Postoperative changes in knee kinematics during gait, and physical function, were evaluated at 3, 6, and 12 months.

RESULTS

The peak flexion angle of the operated limb during weight acceptance was significantly higher than that of the contralateral limb at 3 (operated limb: 34.6 ± 8.9°, contralateral limb: 23.7 ± 8.3°; P < 0.01) and 6 months (operated limb: 32.1 ± 9.7°, contralateral limb: 24.6 ± 8.2°; P = 0.03) postoperatively, but not at 12 months (operated limb: 27.1 ± 7.1°, contralateral limb: 23.1 ± 9.5°; P = 0.22) postoperatively. The knee extensor strength of the operated limb was significantly lower than that of the contralateral limb at 3 (operated limb: 1.00 ± 0.59 Nm/kg, contralateral limb: 1.37 ± 0.59 Nm/kg; P = 0.01), 6 (operated limb: 1.22 ± 0.55 Nm/kg, contralateral limb: 1.48 ± 0.60 Nm/kg; P < 0.01), and 12 months (operated limb: 1.39 ± 0.57 Nm/kg, contralateral limb: 1.55 ± 0.64 Nm/kg; P = 0.04) postoperatively.

CONCLUSION

Knee extension deficits and extensor weakness persisted at 6 months after saucerization and repair of DLM tears. Postoperative rehabilitation should be focused on knee extension function.

摘要

背景

盘状外侧半月板(DLM)撕裂术后的膝关节功能和运动学恢复对改善预后至关重要。然而,这些变化尚不清楚。因此,本研究旨在探讨盘状半月板切除术后膝关节运动学和膝关节功能的变化。

方法

我们纳入了 16 名接受盘状半月板切除和撕裂修复的患者。术后 3、6 和 12 个月评估步态时膝关节运动学和膝关节功能的变化。

结果

在负重期,患侧膝关节的最大屈曲角度在术后 3 个月(患侧:34.6±8.9°,对侧:23.7±8.3°;P<0.01)和 6 个月(患侧:32.1±9.7°,对侧:24.6±8.2°;P=0.03)时显著高于对侧,但在术后 12 个月时差异无统计学意义(患侧:27.1±7.1°,对侧:23.1±9.5°;P=0.22)。术后 3 个月(患侧:1.00±0.59 Nm/kg,对侧:1.37±0.59 Nm/kg;P=0.01)、6 个月(患侧:1.22±0.55 Nm/kg,对侧:1.48±0.60 Nm/kg;P<0.01)和 12 个月(患侧:1.39±0.57 Nm/kg,对侧:1.55±0.64 Nm/kg;P=0.04)时,患侧膝关节伸肌力量明显低于对侧。

结论

盘状半月板切除和撕裂修复术后 6 个月时仍存在膝关节伸肌功能不足和伸肌无力。术后康复应重点关注膝关节伸肌功能。

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