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比较前交叉韧带重建术后 2 年有膝骨关节炎和无膝骨关节炎运动员的矢状面生物力学在下落跳落地时的差异。

Comparing Sagittal-Plane Biomechanics of Drop Jump Landing in Athletes With and Without Knee Osteoarthritis 2-Year Post-Anterior Cruciate Ligament Reconstruction.

机构信息

Department of Rehabilitation Sciences, Jordan University of Science and Technology (JUST), Irbid, Jordan.

Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.

出版信息

J Appl Biomech. 2024 Jul 31;40(5):374-382. doi: 10.1123/jab.2023-0302. Print 2024 Oct 1.

Abstract

The study aimed to determine differences in sagittal-plane joint biomechanics between athletes with and without knee osteoarthritis (OA) during drop vertical jump 2 years after anterior cruciate ligament reconstruction (ACLR). Forty-one athletes with ACLR completed motion analysis testing during drop vertical jump from 30 cm. Sagittal-plane peak joint angles and moments and joint contributions to total support moment (TSM) were calculated during first landing. Medial compartment knee OA of the reconstructed knee was evaluated using Kellgren-Lawrence scores (ACLR group: Kellgren-Lawrence <2; ACLR-OA group: Kellgren-Lawrence ≥2). The ACLR-OA group (n = 13) had higher hip and lower knee contributions in the surgical limb than the ACLR group and their nonsurgical limb. Further, the ACLR-OA group had higher peak hip extension moment than the ACLR group (P = .024). The ACLR-OA group had significantly lower peak knee extension and ankle plantar flexion moments and TSM (P ≤ .032) than ACLR group. The ACLR-OA group landed with increased hip extension moment, decreased knee extension and ankle plantar flexion moments and TSM, and decreased knee and increased hip contributions to TSM compared with ACLR group. The ACLR-OA group may have adopted movement patterns to decrease knee load and compensated by shifting the load to the hip. Clinicians may incorporate tailored rehabilitation programs that mitigate the decreased knee load to minimize the risk of knee OA after ACLR.

摘要

本研究旨在比较前交叉韧带重建(ACL)后 2 年,有和无膝关节骨关节炎(OA)的运动员在进行垂直跳落时矢状面关节生物力学的差异。41 名 ACL 运动员在 30cm 高度进行垂直跳落时完成了运动分析测试。在首次着地时计算了矢状面峰值关节角度和力矩以及关节对总支撑力矩(TSM)的贡献。采用 Kellgren-Lawrence 评分(ACLR 组:Kellgren-Lawrence<2;ACLR-OA 组:Kellgren-Lawrence≥2)评估患侧膝关节的内侧间室 OA。与 ACLR 组及其非手术侧相比,ACLR-OA 组的手术侧髋关节和膝关节贡献更小。此外,ACLR-OA 组的髋关节伸展峰值力矩高于 ACLR 组(P =.024)。与 ACLR 组相比,ACLR-OA 组的膝关节伸展峰值力矩和踝关节跖屈峰值力矩以及 TSM 明显降低(P ≤.032)。与 ACLR 组相比,ACLR-OA 组落地时髋关节伸展力矩增加,膝关节伸展和踝关节跖屈力矩以及 TSM 降低,膝关节贡献降低,髋关节贡献增加。与 ACLR 组相比,ACLR-OA 组可能已经采用了降低膝关节负荷的运动模式,并通过将负荷转移到髋关节来代偿。临床医生可以制定有针对性的康复计划,减轻膝关节负荷,以尽量降低 ACL 后膝关节 OA 的风险。

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