Matthews P, St-Pierre D M
North Country Hospital, Newport, VT, USA.
J Orthop Sports Phys Ther. 1996 Jan;23(1):18-26. doi: 10.2519/jospt.1996.23.1.18.
The purpose of this study was to investigate the time course of spontaneous recovery (no supervised training) of muscle torques in the first 3 months postarthroscopic partial meniscectomy. This information will then be used to plan a clinical trial investigating the effects of rehabilitation following arthroscopic meniscectomy. Knee extensor and flexor strength was evaluated at four different velocities (60, 120, 180, and 240 degrees/sec) preoperatively and every 2 weeks from weeks 2-12 postsurgery. Eight subjects were evaluated on a Cybex II+ and 14 subjects were evaluated on a Cybex II isokinetic device. A repeated measures analysis of variance was used to determine possible side (involved and uninvolved), speed (60, 120, 180, and 240 degrees/sec), or time (preoperative, 2, 4, 6, 8, 10, and 12 weeks postoperatively) effects as well as possible interactions between these factors. Prior to partial meniscectomy, the involved quadriceps was significantly weaker than the uninvolved quadriceps only at 60 degrees/sec (15%). A further decrease in torque was noted at 2 (25-40% deficit depending on the velocity) and 4 weeks postsurgery at all speeds (17-25%). The quadriceps recovered to preoperative values by 4-6 weeks postsurgery and stabilized at this level until the end of the study, at which time the quadriceps remained weaker than the contralateral side at 60 degrees/sec (14%) and 120 degrees/sec (12%). Prior to surgery, the involved hamstrings were comparable with the uninvolved hamstrings. Although significant differences between sides were found at week 2 postsurgery at 60 (23%) and 120 degrees/sec (17%), the hamstrings were fully recovered by 4 weeks postoperatively. In conclusion, although the quadriceps may recover to preoperative levels by 4-6 weeks following partial meniscectomy, further recovery does not appear to be possible without training as the quadriceps remains weaker than the contralateral side up to 12 weeks postsurgery.
本研究的目的是调查关节镜下部分半月板切除术后前3个月肌肉扭矩自发恢复(无监督训练)的时间进程。该信息随后将用于规划一项临床试验,以研究关节镜下半月板切除术后康复的效果。术前以及术后第2周 - 第12周每2周在四种不同速度(60、120、180和240度/秒)下评估膝关节伸肌和屈肌力量。8名受试者在Cybex II+上进行评估,14名受试者在Cybex II等速装置上进行评估。采用重复测量方差分析来确定可能的侧别(患侧和健侧)、速度(60、120、180和240度/秒)或时间(术前、术后2、4、6、8、10和12周)效应以及这些因素之间可能的相互作用。在部分半月板切除术前,仅在60度/秒时患侧股四头肌明显弱于健侧股四头肌(弱15%)。术后第2周(根据速度不同, deficit为25 - 40%)和第4周在所有速度下(弱17 - 25%)扭矩进一步下降。股四头肌在术后4 - 6周恢复到术前值,并在此水平稳定直至研究结束,此时股四头肌在60度/秒(弱14%)和120度/秒(弱12%)时仍弱于对侧。手术前,患侧腘绳肌与健侧腘绳肌相当。虽然术后第2周在60度/秒(弱23%)和120度/秒(弱17%)时两侧存在显著差异,但腘绳肌在术后4周完全恢复。总之,虽然部分半月板切除术后股四头肌可能在4 - 6周恢复到术前水平,但如果不进行训练,进一步恢复似乎不太可能,因为直到术后12周股四头肌仍弱于对侧。