Dutaillis Benjamin, Collings Tyler, Bellinger Philip, Timmins Ryan G, Williams Morgan D, Bourne Mathew N
School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia.
Australian Centre for Precision Health and Technology (PRECISE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
Knee Surg Sports Traumatol Arthrosc. 2025 Jul;33(7):2684-2699. doi: 10.1002/ksa.12694. Epub 2025 May 12.
PURPOSE: To (1) investigate how lower limb strength, vertical jump metrics, and patient reported outcome measures (PROMs) change in the initial 3- to 12-months of recovery following ACLR; and (2) explore which strength and vertical jump metrics best differentiate between lower and higher Knee Osteoarthritis Outcome Score (KOOS) and Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scores. METHODS: Thirty recreationally active athletes undergoing unilateral primary ACLR underwent field-based assessments of knee flexion and extension strength, hip adduction and abduction strength, and double and single leg countermovement (CMJ) and drop vertical jump (DVJ) kinetics at 3-, 6-, 9- and 12-months following surgery. The KOOS and ACL-RSI were also completed. Mixed models were used to investigate how measures of lower limb strength, vertical jump metrics and PROMs change across the first 12-months of rehabilitation. Mixed model decision trees were used to determine which strength and vertical jump measures best discriminated between lower and higher PROMs. RESULTS: Vertical jump height and reactive strength index (RSI) improved significantly over time (p < 0.001), with reductions in contraction and contact times (p < 0.05). Isometric knee extension and eccentric knee flexion strength increased significantly (p < 0.001), as did KOOS and ACL-RSI scores (p < 0.001). Surgically reconstructed limbs displayed deficits in most vertical jump and strength measures compared to the uninjured contralateral limb, although deficits reduced over time with between limb asymmetry deceasing in 70% of these variables (p range: 0.05 to <0.001). Single leg CMJ jump height < 8.4 cm best discriminated between lower and higher ACL-RSI scores (r = 0.67, d = 0.8), whilst knee extension peak force asymmetry < 38.3% best discriminated between lower and higher KOOS scores (r = -0.78, d = 0.9) across the time-course of rehabilitation. CONCLUSION: Most measures of lower limb strength and vertical jump metrics change in both the ACLR and uninjured contralateral limbs across the first 12-months of recovery following primary ACLR. A strong relationship was found between measures of lower limb strength and vertical jump performance with PROMs. LEVEL OF EVIDENCE: Level II, lower quality prospective cohort study.
目的：（1）研究前交叉韧带重建术（ACLR）后最初3至12个月的恢复过程中，下肢力量、垂直跳跃指标以及患者报告结局测量指标（PROMs）如何变化；（2）探讨哪些力量和垂直跳跃指标能最好地区分低和高的膝关节骨关节炎结局评分（KOOS）以及前交叉韧带损伤后恢复运动（ACL-RSI）评分。 方法：30名单侧初次进行ACLR的休闲活跃运动员在术后3、6、9和12个月接受了基于场地的膝关节屈伸力量、髋关节内收和外展力量以及双腿和单腿反向运动（CMJ）和下落垂直跳跃（DVJ）动力学评估。还完成了KOOS和ACL-RSI评估。使用混合模型研究下肢力量、垂直跳跃指标和PROMs在康复的前12个月中的变化情况。使用混合模型决策树来确定哪些力量和垂直跳跃指标能最好地区分低和高的PROMs。 结果：垂直跳跃高度和反应力量指数（RSI）随时间显著改善（p < 0.001）,收缩时间和接触时间减少（p < 0.05）。等长膝关节伸展和离心膝关节屈曲力量显著增加（p < 0.001），KOOS和ACL-RSI评分也显著增加（p < 0.001）。与未受伤的对侧肢体相比，手术重建的肢体在大多数垂直跳跃和力量测量中表现出缺陷，尽管随着时间的推移缺陷减少，这些变量中有70%的肢体间不对称性降低（p范围：0.05至<0.001）。在康复过程中，单腿CMJ跳跃高度<8.4 cm能最好地区分低和高的ACL-RSI评分（r = 0.67，d = 0.8），而膝关节伸展峰值力量不对称性<38.3%能最好地区分低和高的KOOS评分（r = -0.78，d = 0.9）。 结论：在初次ACLR后的前12个月恢复过程中，ACLR肢体和未受伤的对侧肢体的大多数下肢力量和垂直跳跃指标都会发生变化。发现下肢力量和垂直跳跃表现指标与PROMs之间存在密切关系。 证据水平：II级，低质量前瞻性队列研究。
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