Snyder-Mackler L, Fitzgerald G K, Bartolozzi A R, Ciccotti M G
Department of Physical Therapy, University of Delaware, Newark 19716-2590, USA.
Am J Sports Med. 1997 Mar-Apr;25(2):191-5. doi: 10.1177/036354659702500209.
Twenty patients with anterior cruciate ligament-deficient knees were studied. Ten patients returned to all sports activities (compensators) and 10 patients were not improved with nonoperative management and required surgical stabilization (noncompensators). Joint laxity was measured using a KT-2000 arthrometer (manual maximum Lachman). Subjects completed a Lysholm questionnaire and Knee Outcome Score. The International Knee Documentation Committee form was also completed. Patients also rated their knee function on a scale of 1 to 100. There was no difference in level and frequency of athletic activity between the two groups before their anterior cruciate ligament injuries as determined by the knee outcome score. The compensator group had a mean side-to-side difference of 3.25 mm at 89 N and the noncompensators had a mean difference of 3 mm preoperatively. Manual maximum tests gave side-to-side differences of 6.7 mm for the compensators and 6 mm for the noncompensators. There were no differences in laxity measures between groups. The correlation between knee outcome scores and side-to-side laxity measurements were not significant. Measurements of anterior laxity in anterior cruciate ligament-deficient patients were not correlated with measures of functional outcome used in this study. Functional outcome measurements that are partially based on joint laxity measures, such as the International Knee Documentation Committee form, may artificially overestimate the disability after anterior cruciate ligament rupture.
对20例前交叉韧带损伤的膝关节患者进行了研究。10例患者恢复了所有体育活动(代偿者),10例患者非手术治疗效果不佳,需要手术稳定(非代偿者)。使用KT-2000关节测量仪(手动最大拉赫曼试验)测量关节松弛度。受试者完成了Lysholm问卷和膝关节结果评分。还填写了国际膝关节文献委员会表格。患者还对其膝关节功能进行了1至100分的评分。根据膝关节结果评分,两组在前交叉韧带损伤之前的运动活动水平和频率没有差异。代偿者组在89 N时的平均左右差异为3.25 mm,非代偿者术前的平均差异为3 mm。手动最大试验中,代偿者的左右差异为6.7 mm,非代偿者为6 mm。两组之间的松弛度测量没有差异。膝关节结果评分与左右松弛度测量之间的相关性不显著。前交叉韧带损伤患者的前向松弛度测量与本研究中使用的功能结果测量不相关。部分基于关节松弛度测量的功能结果测量,如国际膝关节文献委员会表格,可能会人为高估前交叉韧带断裂后的残疾程度。