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前交叉韧带重建术后正常步态模式的恢复

Return of normal gait patterns after anterior cruciate ligament reconstruction.

作者信息

Timoney J M, Inman W S, Quesada P M, Sharkey P F, Barrack R L, Skinner H B, Alexander A H

机构信息

Department of Orthopaedic Surgery, Naval Hospital, Oakland, CA 94627-5000.

出版信息

Am J Sports Med. 1993 Nov-Dec;21(6):887-9. doi: 10.1177/036354659302100623.

Abstract

Individuals with anterior cruciate ligament deficiency typically do not have quadriceps activity during stance. This aberrant pattern has been termed "quadriceps avoidance" gait. We performed gait analysis during walking on 10 normal controls and 10 subjects 8 to 12 months after they had anterior cruciate ligament reconstruction using autogenous middle third of the patellar tendon. All patients had good subjective and objective results at the time of analysis. Differences in gait between subjects and controls persisted up to 12 months after surgery. Specifically, subjects with anterior cruciate ligament reconstructions demonstrated significant reductions in midstance knee flexion moments (P < 0.01) and tibially directed loading rates (P < 0.05) when compared with controls. However, the subjects had a net external flexion moment throughout most of the stance phase of gait, implying that quadriceps activity was present. After anterior cruciate ligament reconstruction, there is a tendency toward gait normalization, and a quadriceps avoidance mechanism is no longer present.

摘要

前交叉韧带损伤的个体在站立期通常没有股四头肌活动。这种异常模式被称为“股四头肌回避”步态。我们对10名正常对照者和10名在使用自体髌腱中三分之一进行前交叉韧带重建术后8至12个月的受试者进行了步行时的步态分析。所有患者在分析时主观和客观结果均良好。受试者与对照者之间的步态差异在术后长达12个月时仍然存在。具体而言,与对照者相比,前交叉韧带重建的受试者在步态中期站立时的膝关节屈曲力矩显著降低(P < 0.01),胫骨方向的负荷率也显著降低(P < 0.05)。然而,受试者在步态的大部分站立期都有一个净外部屈曲力矩,这意味着存在股四头肌活动。前交叉韧带重建术后,有步态正常化的趋势,并且不再存在股四头肌回避机制。

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