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年轻患者前交叉韧带手术后膝关节周围肌肉的生物力学——自体移植重建与缝线带增强一期修复的比较

Biomechanics of periarticular knee muscles after ACL surgery in young patients - comparison of autograft reconstruction and suture-tape augmented primary repair.

作者信息

Zalewska Paulina, Góralczyk Adrian, Guszczyn Tomasz, Hermanowicz Krzysztof, Piszczatowski Szczepan

机构信息

1Institute of Biomedical Engineering, Bialystok University of Technology, Białystok, Poland.

2Humana Medica Omeda, Departament of Orthopaedics, Białystok, Poland.

出版信息

Acta Bioeng Biomech. 2025 Jun 16;27(1):57-67. doi: 10.37190/abb-02564-2024-02. Print 2025 Mar 1.

DOI:10.37190/abb-02564-2024-02
PMID:40239178
Abstract

: Last years brought a growing interest in suture-tape augmented ACL repair techniques instead of ACL reconstructions with autografts due to their limited success rates. However, there is a lack of experimental studies comparing the infl uence of both procedures on knee periarticular muscles biomechanics. The aim of the study was to analyze periarticular muscles torq ue and their activity during movement for young patients after ACL repair (IB) and ACL reconstruction (ACLR), compare them with each other and with a healthy subjects (Controls). : Isokinetic torques of knee flexors and extensors and their EMG activity during gait and drop vertical jump (DVJ) were measured in 48 patients (IB - 20, ACLR - 28) at least one year after surgery and in 25 healthy controls. : The muscle torques in the operated limb were lower in both group of patients comparing to Controls, but IB scored the lowest values (79% of Controls for extensors, = 0.005; 74% for flexors, = 0.001). Decrease of muscle torques in the contralateral limb occurred only in IB group (84% of Controls for both extensors ( = 0.045) and flexors). Increased hamstrings activity were noticed for ACLR comparing to IB and Controls. The balance between activity of muscles actin g on the medial and lateral side of the knee for ACLR tilts more towards the lateral side. : Increased hamstrings activity and changes in balance between laterally and medially located muscles indicate on the increased need for muscle support of kn ee stability in ACLR patients.

摘要

近年来,由于自体移植重建前交叉韧带(ACL)成功率有限,人们对缝线带增强ACL修复技术的兴趣日益浓厚。然而,缺乏实验研究来比较这两种手术对膝关节周围肌肉生物力学的影响。本研究的目的是分析ACL修复(IB)和ACL重建(ACLR)术后年轻患者运动过程中膝关节周围肌肉的扭矩及其活动情况,将其相互比较,并与健康受试者(对照组)进行比较。

在48例患者(IB组20例,ACLR组28例)术后至少一年以及25例健康对照者中,测量了膝关节屈伸肌的等速扭矩及其在步态和垂直跳(DVJ)过程中的肌电图活动。

与对照组相比,两组患者患侧肢体的肌肉扭矩均较低,但IB组得分最低(伸肌为对照组的79%,P = 0.005;屈肌为74%,P = 0.001)。对侧肢体肌肉扭矩降低仅发生在IB组(伸肌和屈肌均为对照组的84%,P = 0.045)。与IB组和对照组相比,ACLR组的腘绳肌活动增加。ACLR组膝关节内外侧肌肉活动的平衡更倾向于外侧。

ACLR组腘绳肌活动增加以及内外侧肌肉平衡的变化表明,ACLR患者对膝关节稳定性肌肉支持的需求增加。

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