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前交叉韧带重建时机对术后运动表现和本体感觉的影响。

Effects of Anterior Cruciate Ligament Reconstruction Timing on Post-Operative Motor Performance and Proprioception.

作者信息

Wang Xiang-Yi, Sun Jing-Yi, He Chen, Qian Yi, Guo Sen, Zhang Xiao-Han, Xu Hao, Liu Zhuang, Gong Ya-Wei, Li Lei, Liu Ming-Ze, Gao Feng, Zhou Jing-Bin

机构信息

Binzhou Medical University,Yantai,Shandong 264003,China.

National Institution of Sports Medicine,General Administration of Sport of China,Beijing 100061,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2024 Dec;46(6):797-804. doi: 10.3881/j.issn.1000-503X.16059.

Abstract

Objective To evaluate the effects of anterior cruciate ligament (ACL) reconstruction timing on the motor performance and proprioception by clinical evaluation as well as proprioception and motor performance tests on the patients more than 2 years after ACL reconstruction. Methods The patients who underwent ACL reconstruction in the National Institute of Sports Medicine,General Administration of Sport of China from January 2015 to January 2021 and met the inclusion criteria were followed up,and the postoperative data were collected retrospectively.Fifty-six patients who met the inclusion criteria were included in this study and categorized into two groups:early surgery (=28,who underwent ACL reconstruction ≤3 weeks after injury) and delayed surgery (=28,who underwent ACL reconstruction >3 weeks after injury).The basic information,clinical evaluation results,proprioception,and motor performance were compared between the two groups. Results The ACL return to sport after injury scale (ACL-RSI) score in the early surgery group was higher than that in the delayed surgery group [(68.68±22.04)scores (55.82±24.87)scores,=0.045].There was no difference in the range of motion of the knee joint,the positive rate of pivot shift test,or the scores of Tegner,Marx,Lysholm,knee injury and osteoarthritis outcome score (KOOS),and international knee documentation committee (IKDC) between the two groups (all >0.05).Although there was no significant difference in range of motion of the knee joint between the two groups,the proportion of knee flexion and extension affected in the early surgery group was smaller than that in the delayed surgery group.Neither motor performance (isokinetic strength test,Y-balance test,and single-leg jump test) nor proprioception had difference between the two groups (all >0.05). Conclusions Early ACL reconstruction outperformed delayed ACL reconstruction in improving the psychological health,emotions,and confidence in returning to sport,accelerating functional recovery of the patients.The timing of ACL reconstruction has no significant effect on the short-term postoperative knee stability,knee function,motor performance,or proprioceptive recovery of the patients.Early ACL reconstruction is recommended for improving the clinical outcomes.

摘要

目的 通过临床评估以及对前交叉韧带(ACL)重建术后2年以上患者进行本体感觉和运动功能测试,评估ACL重建时机对运动表现和本体感觉的影响。方法 对2015年1月至2021年1月在中国国家体育总局运动医学研究所接受ACL重建且符合纳入标准的患者进行随访,回顾性收集术后数据。本研究纳入56例符合纳入标准的患者,分为两组:早期手术组(n = 28,受伤后≤3周接受ACL重建)和延迟手术组(n = 28,受伤后>3周接受ACL重建)。比较两组的基本信息、临床评估结果、本体感觉和运动表现。结果 早期手术组的ACL伤后恢复运动量表(ACL-RSI)评分高于延迟手术组[(68.68±22.04)分 vs.(55.82±24.87)分,P = 0.045]。两组膝关节活动范围、轴移试验阳性率、Tegner、Marx、Lysholm、膝关节损伤和骨关节炎疗效评分(KOOS)以及国际膝关节文献委员会(IKDC)评分比较,差异均无统计学意义(均P>0.05)。虽然两组膝关节活动范围差异无统计学意义,但早期手术组膝关节屈伸受影响的比例小于延迟手术组。两组在运动表现(等速肌力测试、Y平衡测试和单腿跳测试)和本体感觉方面均无差异(均P>0.05)。结论 在改善患者心理健康、情绪和恢复运动的信心以及加速功能恢复方面,早期ACL重建优于延迟ACL重建。ACL重建时机对患者术后短期膝关节稳定性、膝关节功能、运动表现或本体感觉恢复无显著影响。建议早期进行ACL重建以改善临床结局。

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