Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
University of Nebraska Medical Center, Omaha, Nebraska, USA.
Knee Surg Sports Traumatol Arthrosc. 2024 Aug;32(8):1953-1960. doi: 10.1002/ksa.12217. Epub 2024 Apr 30.
To retrospectively compare strength outcomes of individuals undergoing postoperative rehabilitation following quadriceps tendon (QT) autograft anterior cruciate ligament reconstruction (ACLR) with and without blood flow restriction therapy.
A retrospective review of consecutive patients undergoing ACLR with QT autograft with a minimum of two quantitative postoperative isometric strength assessments via an electromechanical dynamometer (Biodex) was included. Demographics, surgical variables and strength measurement outcomes were compared between patients undergoing blood flow restriction therapy as part of postoperative rehabilitation versus those who did not.
Eighty-one (81) patients met the inclusion criteria. No differences were found in demographic and surgical characteristics between those who received blood flow restriction compared with those who did not. While both groups had improvements in quadriceps peak torque and limb symmetry index (LSI; defined as peak torque of the operative limb divided by the peak torque of the nonoperative limb) over the study period, the blood flow restriction group had significantly lower mean peak torque of the operative limb at first Biodex strength measurement (95.6 vs. 111.2 Nm; p = 0.03). Additionally, the blood flow restriction group had a significantly lower mean LSI than those with no blood flow restriction at the second Biodex measurement timepoint (81% vs. 90%; p = 0.02). No other significant differences were found between the strength outcomes measured.
Results of this study show that the 'real world' clinical implementation of blood flow restriction therapy to the postoperative rehabilitation protocol following QT autograft ACLR did not result in an increase in absolute or longitudinal changes in quadriceps strength measurements. A better understanding and standardisation of the use of blood flow restriction therapy in the rehabilitation setting is necessary to delineate the true effects of this modality on strength recovery after QT autograft ACLR.
Level III.
回顾性比较接受股四头肌肌腱（QT）自体移植物前交叉韧带重建（ACLR）术后康复并接受和不接受血流限制治疗的个体的力量结果。
本研究回顾性纳入了连续接受 ACLR 联合 QT 自体移植物的患者，这些患者至少接受了两次通过机电测力计（Biodex）进行的定量术后等长力量评估。对接受血流限制治疗作为术后康复一部分的患者与未接受血流限制治疗的患者进行了比较，比较了患者的人口统计学、手术变量和力量测量结果。
81 例（81 例）患者符合纳入标准。接受血流限制治疗的患者与未接受血流限制治疗的患者在人口统计学和手术特征方面没有差异。虽然两组的股四头肌峰值扭矩和肢体对称性指数（LSI；定义为手术侧的峰值扭矩除以非手术侧的峰值扭矩）在研究期间都有所改善，但血流限制组在第一次 Biodex 力量测量时的手术侧平均峰值扭矩明显较低（95.6 比 111.2 Nm；p=0.03）。此外，血流限制组在第二次 Biodex 测量时间点的 LSI 平均值明显低于无血流限制组（81%比 90%；p=0.02）。在测量的力量结果之间没有发现其他显著差异。
本研究结果表明，在 QT 自体移植物 ACLR 术后康复方案中实际应用血流限制治疗并没有导致股四头肌力量测量的绝对值或纵向变化增加。有必要更好地理解和规范血流限制治疗在康复环境中的应用，以阐明这种治疗模式对 QT 自体移植物 ACLR 后力量恢复的真正影响。
III 级。
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