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前交叉韧带重建术后股四头肌力量和功能能力。髌腱自体移植与异体移植对比。

Quadriceps strength and functional capacity after anterior cruciate ligament reconstruction. Patellar tendon autograft versus allograft.

作者信息

Lephart S M, Kocher M S, Harner C D, Fu F H

机构信息

Department of Orthopaedic Surgery, University of Pittsburgh, PA 15261.

出版信息

Am J Sports Med. 1993 Sep-Oct;21(5):738-43. doi: 10.1177/036354659302100519.

Abstract

Harvesting the central third of the patellar tendon for autograft anterior cruciate ligament reconstruction is thought to compromise quadriceps strength and functional capacity. We compared objective measurements of quadriceps strength and functional capacity in athletes after patellar tendon autograft or allograft anterior cruciate ligament reconstruction. We looked at 33 active male patients (mean age, 24.3 years) who had anterior cruciate ligament reconstructions 12 to 24 months earlier using patellar tendon autograft (N = 15) or allograft (N = 18) techniques. All patients underwent an intensive rehabilitation program. Quadriceps strength and power were assessed by measuring peak torque at 60 and 240 deg/sec, torque acceleration energy at 240 deg/sec, and the quadriceps index using a Cybex II isokinetic testing device. Functional capacity was evaluated based on the results of 3 specially designed functional performance tests and the hop test. Results revealed no significant difference between autograft and allograft groups with respect to any of these parameters. These findings indicate that harvesting the central third of the patellar tendon for autograft anterior cruciate ligament reconstruction does not diminish quadriceps strength or functional capacity in highly active patients who have intensive rehabilitation. Thus, the recommendation to avoid patellar tendon autograft anterior cruciate ligament reconstruction to preserve quadriceps strength and functional capacity may be unnecessary.

摘要

采用髌腱中三分之一进行自体移植重建前交叉韧带,被认为会损害股四头肌力量和功能能力。我们比较了髌腱自体移植或同种异体移植重建前交叉韧带后运动员股四头肌力量和功能能力的客观测量结果。我们观察了33名活跃男性患者(平均年龄24.3岁),他们在12至24个月前采用髌腱自体移植(N = 15)或同种异体移植(N = 18)技术进行了前交叉韧带重建。所有患者均接受了强化康复计划。使用Cybex II等速测试设备,通过测量60度/秒和240度/秒时的峰值扭矩、240度/秒时的扭矩加速能量以及股四头肌指数来评估股四头肌力量和功率。基于3项专门设计的功能性能测试和单腿跳测试结果评估功能能力。结果显示,在这些参数中的任何一项上,自体移植组和同种异体移植组之间均无显著差异。这些发现表明,对于接受强化康复的高活动量患者,采用髌腱中三分之一进行自体移植重建前交叉韧带不会削弱股四头肌力量或功能能力。因此,为保留股四头肌力量和功能能力而避免髌腱自体移植重建前交叉韧带的建议可能是不必要的。

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