Zwolski Christin M, Poston Grant R, Anthony Laine A, Bastian Kristin L, Sayre Megan M, Hugentobler Kathleen M, Filipa Alyson R
Division of Occupational Therapy and Physical Therapy Cincinnati Children's Hospital Medical Center.
Division of Sports Medicine Cincinnati Children's Hospital Medical Center.
Int J Sports Phys Ther. 2025 Mar 1;20(3):333-343. doi: 10.26603/001c.129257. eCollection 2025.
Knee strength is a critical measure of successful rehabilitation following medial patellofemoral ligament reconstruction (MPFLR). Yet, strength outcomes of youth following MPFLR are not widely reported.
HYPOTHESIS/PURPOSE: The primary purpose was to profile isokinetic strength outcomes by sex and age among youth following MPFLR. A secondary purpose was to determine the relationship between normalized isokinetic strength values and patient-reported outcome scores by age and sex. The hypotheses were that 1) males would demonstrate higher normalized strength, and that 2) a higher proportion of males would achieve ≥90% limb symmetry when compared to females.
Cross-sectional.
At 6.9±2.1 months after MPFLR, 162 patients completed isokinetic assessment of knee extension (KE) and flexion (KF) strength at 180°/s and 300°/s on both limbs (uninvolved [UN], involved [INV]). Strength data and patient-reported outcome scores, including the International Knee Documentation Committee (IKDC) Subjective Knee Form and Pediatric Quality of Life Inventory (PedsQL) were extracted from electronic medical records. Descriptive statistics were used to categorize data by age (Pre-adolescent, Early Adolescent, Late Adolescent, Young Adult) and sex. Independent-samples t-tests and chi-square analyses were used to determine sex-based differences in strength. Multiple linear regression analyses were used to determine the relationship between strength and patient-reported function.
Among Early Adolescents, males demonstrated higher normalized KE strength at 300°/s compared to females (UN: 1.27±0.3 vs. 1.07±0.3 [p=0.01]; INV: 1.07±0.2 vs. 0.92±0.3 [p=0.03]). Among Late Adolescents, males demonstrated higher INV limb strength for KE 180°/s (1.55±0.53 vs. 1.24±0.5; p=0.02), KE 300°/s (1.25±0.4 vs. 1.00±0.4; p=0.01), and KF 180°/s (0.98±0.4 vs. 0.82±0.3; p=0.05). A higher proportion of Late Adolescent and Young Adult males achieved ≥90% LSI compared to females (p=<0.01-0.04). Regression models estimating IKDC and PedsQL scores were significant with INV KE strength as an independent variable (p=0.01-0.03).
Males demonstrated higher normalized strength and symmetry compared to females following MPFLR. Higher INV KE strength was associated with higher patient-reported function.
2b.
膝关节力量是髌股内侧韧带重建（MPFLR）后康复成功的关键指标。然而，MPFLR后青少年的力量结果尚未得到广泛报道。
假设/目的：主要目的是描述MPFLR后青少年按性别和年龄划分的等速肌力结果。次要目的是确定按年龄和性别划分的标准化等速肌力值与患者报告的结局评分之间的关系。假设为：1）男性将表现出更高的标准化力量；2）与女性相比，达到肢体对称性≥90%的男性比例更高。
横断面研究。
在MPFLR后6.9±2.1个月，162例患者在180°/秒和300°/秒的速度下对双下肢（健侧[UN]、患侧[INV]）进行了膝关节伸展（KE）和屈曲（KF）力量的等速评估。从电子病历中提取力量数据和患者报告的结局评分，包括国际膝关节文献委员会（IKDC）主观膝关节表和儿童生活质量量表（PedsQL）。描述性统计用于按年龄（青春期前、青春期早期、青春期晚期、青年）和性别对数据进行分类。独立样本t检验和卡方分析用于确定力量的性别差异。多元线性回归分析用于确定力量与患者报告的功能之间的关系。
在青春期早期，男性在300°/秒时的标准化KE力量高于女性（健侧：1.27±0.3对1.07±0.3[p=0.01]；患侧：1.07±0.2对0.92±0.3[p=0.03]）。在青春期晚期，男性在180°/秒的KE（1.55±0.53对1.24±0.5；p=0.02）、300°/秒的KE（1.25±0.4对1.00±0.4；p=0.01）和180°/秒的KF（0.98±0.4对0.82±0.3；p=0.05）方面患侧肢体力量更高。与女性相比，青春期晚期和青年男性达到肢体对称性指数（LSI）≥90%的比例更高（p=<0.01-0.04）。以患侧KE力量作为自变量估计IKDC和PedsQL评分的回归模型具有显著性（p=0.01-0.03）。
与女性相比，MPFLR后男性表现出更高的标准化力量和对称性。患侧KE力量越高，患者报告的功能越好。
2b。
