Dauty Marc, Geffroy Loïc, Chalopin Antoine, Menu Pierre, Grondin Jérôme, Hirardot Thomas, Crenn Vincent, Fouasson-Chailloux Alban
Nantes Université, Médecine Physique et Réadaptation Locomotrice et Respiratoire, Médecine du sport, CHU Nantes, 44093 Nantes, France; Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, ONIRIS, Nantes Université, 44042 Nantes, France; Institut Régional de Médecine du Sport (IRMS) des Pays de Loire, 44093 Nantes, France.
Nantes Université, Médecine Physique et Réadaptation Locomotrice et Respiratoire, Médecine du sport, CHU Nantes, 44093 Nantes, France; Santé Atlantique, Chirurgie Orthopédie Pédiatrique, Avenue Claude Bernard, 44800 Saint-Herblain, France.
J ISAKOS. 2025 Jun;12:100901. doi: 10.1016/j.jisako.2025.100901. Epub 2025 May 11.
Knee muscle strength recovery after anterior cruciate ligament reconstruction is usually evaluated using isokinetic limb symmetry index to help take the decision to allow return to the previous sport. However, the role of age on knee strength recovery is not well known. So, we aimed to compare the isokinetic knee muscle strength recovery according to age at 4 and 7 months after anterior cruciate ligament reconstruction using hamstring graft.
From a historical cohort (2018-2023) of patients who completed isokinetic monitoring at 4 and 7 months after anterior cruciate ligament reconstruction using hamstring graft, two groups were compared according to age: ≤19 and > 20 years old. The quadriceps and hamstring limb symmetry indexes were studied as the main parameters. A multivariate analysis was realized to assess the weight of potential inter-subject explanatory parameters on knee strength evolution.
Two hundred fifty-three adolescents were compared with 247 adults. The adolescent quadriceps symmetry index at 60°/s was significantly higher than that of adults (79% vs 72% and 88% vs 82% at 4 and 7 months of follow-up, respectively). The hamstring symmetry index was not statistically significantly different. No inter-subject explanatory parameters were found after the multivariate analysis.
Knee strength recovers faster in adolescents than in adults after anterior cruciate ligament reconstruction using hamstring graft. This result should be carefully considered because adolescents could be exposed to return to sport too early, while the risk of graft rupture is still high, if strength cutoff is only considered.
III.
前交叉韧带重建术后膝关节肌肉力量的恢复通常采用等速肢体对称指数进行评估，以辅助决定是否允许患者恢复到之前的运动水平。然而，年龄对膝关节力量恢复的作用尚不明确。因此，我们旨在比较采用腘绳肌肌腱移植进行前交叉韧带重建术后4个月和7个月时，不同年龄患者的膝关节等速肌肉力量恢复情况。
从一个历史队列（2018 - 2023年）中选取接受腘绳肌肌腱移植进行前交叉韧带重建术后4个月和7个月完成等速监测的患者，根据年龄分为两组：≤19岁和>20岁。以股四头肌和腘绳肌的肢体对称指数作为主要参数进行研究。采用多变量分析评估个体间潜在解释参数对膝关节力量变化的影响。
253名青少年与247名成年人进行了比较。青少年在60°/s时的股四头肌对称指数显著高于成年人（随访4个月和7个月时分别为79%对72%以及88%对82%）。腘绳肌对称指数在统计学上无显著差异。多变量分析后未发现个体间的解释参数。
采用腘绳肌肌腱移植进行前交叉韧带重建术后，青少年的膝关节力量恢复比成年人更快。如果仅考虑力量阈值，由于青少年过早恢复运动的风险仍然很高，而移植物破裂的风险依然存在，因此这一结果应谨慎考虑。
III级
