Kong Lingchuang, Lai Huahao, Zeng Xiaolong, Gao Peng, Liang Wenhao, Gao Qi, Kong Zhiyuan, Wu Wu, Wu Xiaona, Zhang Tao
Department of Orthopedics, General Hospital of Southern Theatre Command of People's Liberation Army, Guangzhou, China.
Department of Bone and Joint Rehabilitation, Guangdong Work Injury Rehabilitation Hospital, Guangzhou, Guangdong, China.
Front Bioeng Biotechnol. 2025 Apr 23;13:1572160. doi: 10.3389/fbioe.2025.1572160. eCollection 2025.
This study aims to explore the dynamic changes in the six degrees of freedom (6DOF) kinematics of the knee joint in patients within one year after anterior cruciate ligament reconstruction (ACLR), combined with clinical scoring systems to analyze functional recovery characteristics, providing scientific evidence for optimizing postoperative rehabilitation strategies.
The study enrolled 49 patients followed up at 3 months postoperatively, 33 patients at 6 months, and 35 patients at 12 months. Twenty-nine healthy controls were recruited. A three-dimensional motion capture system was used to collect 6DOF knee kinematic data at 3, 6, and 12 months after surgery, including flexion-extension, internal-external rotation, adduction-abduction angles, and anterior-posterior, distal-proximal, medial-lateral translation data. Clinical function was assessed using the IKDC and KOOS scores. One Way ANOVA of one-dimensional statistical parametric mapping (SPM1D) was used to assess the changes in gait kinematics and differences compared to healthy controls.
After ACLR, the IKDC and KOOS scores of patients significantly improved between 3 and 12 months postoperatively, showing good subjective functional recovery. Over the course of one year, the knee kinematic data of gait has gradually recovered. However, abnormalities in knee joint kinematics still exist. In the coronal plane, the adduction angle of the knee joint during motion is relatively large (p < 0.05); In the sagittal plane, the flexion angle increased during the standing phase (p < 0.05); In the transverse plane, the internal rotation angle of the knee joint increased compared to the controls (p < 0.05). The range of motion of flexion and rotational angles decreased compared to the controls (p < 0.05).
The kinematic recovery of the knee joint in ACLR patients presents multidimensional characteristics and dynamic changes. The recovery rates and patterns differ significantly across dimensions, with some abnormalities not fully corrected within one-year post-urgery. These findings provide scientific evidence for individualized rehabilitation strategies, emphasizing the need for strengthening joint stability and range of motion recovery in the early postoperative phase (0-6 months) and focusing on correcting rotational and flexion-extension function during the later phase (6-12 months) to further improve knee function and prevent long-term adverse outcomes.
本研究旨在探讨前交叉韧带重建（ACLR）术后一年内患者膝关节六自由度（6DOF）运动学的动态变化，并结合临床评分系统分析功能恢复特征，为优化术后康复策略提供科学依据。
本研究纳入术后3个月随访的49例患者、6个月随访的33例患者和12个月随访的35例患者。招募了29名健康对照者。使用三维运动捕捉系统在术后3、6和12个月收集膝关节6DOF运动学数据，包括屈伸、内外旋、内收外展角度以及前后、远近端、内外侧平移数据。使用IKDC和KOOS评分评估临床功能。采用一维统计参数映射（SPM1D）的单因素方差分析来评估步态运动学的变化以及与健康对照者的差异。
ACLR术后，患者的IKDC和KOOS评分在术后3至12个月显著改善，显示出良好的主观功能恢复。在一年的时间里，步态的膝关节运动学数据逐渐恢复。然而，膝关节运动学异常仍然存在。在冠状面，运动期间膝关节的内收角度相对较大（p < 0.05）；在矢状面，站立期屈曲角度增加（p < 0.05）；在横断面，膝关节的内旋角度与对照组相比增加（p < 0.05）。屈伸和旋转角度的活动范围与对照组相比减小（p < 0.05）。
ACLR患者膝关节的运动学恢复呈现多维度特征和动态变化。各维度的恢复率和模式差异显著，一些异常在术后一年内未完全纠正。这些发现为个性化康复策略提供了科学依据，强调在术后早期（0 - 6个月）需要加强关节稳定性和活动范围恢复，并在后期（6 - 12个月）着重纠正旋转和屈伸功能，以进一步改善膝关节功能并预防长期不良后果。
