Hunnicutt Jennifer, Collins Hannah, McLeod Michelle, Gregory Chris, Slone Harris, Pfile Kate
Medical University of South Carolina, Charleston, South Carolina, U.S.A.
College of Charleston, Charleston, South Carolina, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Jul 30;6(6):100981. doi: 10.1016/j.asmr.2024.100981. eCollection 2024 Dec.
To compare the biomechanics of a drop vertical jump (DVJ) landing task and functional outcomes among patients with anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon (QT) and patellar tendon (PT) autografts.
Physically active patients who underwent primary ACLR with either a QT or PT autograft were included in this study. All were within 6 months to 2 years after surgery and cleared for return to physical activity. Subjects completed DVJs in a biomechanics laboratory. Peak vertical ground reaction force (VGRF) and lower-extremity joint sagittal and frontal plane kinematics and kinetics were collected and analyzed. Mann-Whitney tests were used to compare the surgical limbs of the QT and PT autograft groups for kinematic and kinetic variables. Wilcoxon rank-sum tests were used to compare the surgical and nonsurgical limbs for both the QT and PT autograft groups.
Twenty-four physically active individuals who underwent primary ACLR with QT (n = 14) or PT (n = 10) autografts completed DVJs in a biomechanics laboratory. There were no statistically significant biomechanical differences between the QT and PT groups. Peak VGRF differed between the surgical and nonsurgical limbs for the QT (surgical and nonsurgical, 1.10 and 1.30 N) and PT (surgical and nonsurgical, 1.10 and 1.35 N) groups. Specifically, both groups demonstrated lower VGRFs in the surgical limb compared with the nonsurgical limb ( < .05). Additional medium and large effect sizes were found when comparing kinetic variables between limbs within both surgical groups.
Regardless of the graft-specific surgical technique, patients who undergo ACLR are returning to activity with movements that resemble an offloading pattern of the surgical limb. Coupled with the finding of an absence of differences in kinematic and kinetic variables between the QT and PT autograft groups suggests that the QT graft may be a viable alternate graft source for ACLR.
Level III, retrospective comparative study.
比较采用股四头肌腱(QT)和髌腱(PT)自体移植进行前交叉韧带重建(ACLR)的患者在垂直下落跳(DVJ)着陆任务中的生物力学和功能结果。
本研究纳入了接受QT或PT自体移植进行初次ACLR的身体活跃患者。所有患者均在术后6个月至2年内,且已获准恢复体育活动。受试者在生物力学实验室完成DVJ。收集并分析垂直地面反作用力(VGRF)峰值以及下肢关节矢状面和额状面的运动学和动力学数据。采用曼-惠特尼检验比较QT和PT自体移植组手术侧肢体的运动学和动力学变量。采用威尔科克森秩和检验比较QT和PT自体移植组手术侧和非手术侧肢体。
24名接受QT(n = 14)或PT(n = 10)自体移植进行初次ACLR的身体活跃个体在生物力学实验室完成了DVJ。QT组和PT组之间在生物力学上无统计学显著差异。QT组(手术侧和非手术侧分别为1.10和1.30 N)和PT组(手术侧和非手术侧分别为1.10和1.35 N)手术侧和非手术侧肢体的VGRF峰值存在差异。具体而言,与非手术侧肢体相比,两组手术侧肢体的VGRF均较低(P <.05)。在比较两个手术组内肢体间的动力学变量时,还发现了中等和较大的效应量。
无论采用何种特定的移植手术技术,接受ACLR的患者在恢复活动时,其动作类似于手术侧肢体的卸载模式。再加上QT和PT自体移植组在运动学和动力学变量上无差异这一发现,表明QT移植物可能是ACLR的一种可行替代移植物来源。
III级,回顾性比较研究。