Shelbourne K D, Klootwyk T E, Wilckens J H, De Carlo M S
Methodist Sports Medicine Center, Indianapolis, Indiana, USA.
Am J Sports Med. 1995 Sep-Oct;23(5):575-9. doi: 10.1177/036354659502300510.
We studied patients who participated in our accelerated rehabilitation program after anterior cruciate ligament reconstructive surgery to determine if they showed signs of patellar tendon graft stretching. This program initiated in 1987 emphasizes early full hyperextension, early weightbearing as tolerated, and closed-chain functional activities with rapid return to sports when the patient has attained full range of motion, approximately 65% of strength, and has accomplished the running and agility drills prescribed. A total of 209 patients met the criteria of KT-1000 arthrometer followup at the time full range of motion (5 degrees/0 degrees/135 degrees) was attained and at 2 years or more after surgery. The KT-1000 arthrometer manual maximum difference between the reconstructed and normal knees was used as the indicator of change in the graft length. All patients completed postoperative subjective questionnaires. The mean KT-1000 arthrometer value was 2.06 mm (SD, +/- 2.2) at full range of motion and 2.10 mm (SD, +/- 1.9) at more than 2 years of followup (P = 0.7961). The patients' subjective stability scores averaged 19.6 with 97% reporting no instability episodes. Based on our findings, we conclude that an accelerated rehabilitation program after this type of reconstruction does not affect long-term stability as measured by the KT-1000 arthrometer.
我们对在接受前交叉韧带重建手术后参与我们加速康复计划的患者进行了研究,以确定他们是否表现出髌腱移植物拉伸的迹象。该计划始于1987年,强调早期完全伸直、早期根据耐受情况进行负重,以及进行闭链功能活动,当患者达到全关节活动范围、约65%的力量,并完成规定的跑步和敏捷性训练后迅速恢复运动。共有209例患者在达到全关节活动范围(5度/0度/135度)时以及术后2年或更长时间时符合KT-1000关节测量仪随访标准。将重建膝关节与正常膝关节之间KT-1000关节测量仪手动测量的最大差值用作移植物长度变化的指标。所有患者均完成了术后主观问卷调查。全关节活动范围时KT-1000关节测量仪的平均值为2.06毫米(标准差,±2.2),随访2年以上时为2.10毫米(标准差,±1.9)(P = 0.7961)。患者主观稳定性评分平均为19.6分,97%的患者报告无不稳定发作。根据我们的研究结果,我们得出结论,这种类型重建后的加速康复计划不会影响通过KT-1000关节测量仪测量的长期稳定性。