前交叉韧带重建后股四头肌肌力和髌股关节软骨损伤的相关性

Relationship between Quadriceps Strength and Patellofemoral Joint Chondral Lesions after Anterior Cruciate Ligament Reconstruction
2015-09-29 08:11发表评论
作者:Wang, H.-J., Ao, Y.-F., Jiang, D., Gong, X., Wang, Y.-J., Wang, J., Yu, J.-K
机构: 北京大学第三医院 运动医学研究所
期刊: AM J SPORT MED2015年9月9期43卷

Background: The incidence of the patellofemoral joint chondral lesions after anterior cruciate ligament reconstruction (ACLR) is disturbingly high. Few studies have assessed the factors affecting patellofemoral joint chondral lesions postoperatively. Hypothesis: The recovery of quadriceps strength after ACLR could be associated with patellofemoral joint cartilage damage. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 88 patients who underwent arthroscopic anatomic double-bundle ACLR with hamstring autografts received second-look arthroscopy at the time of metal staple removal at an average of 24.1 months (range, 12-51 months) postoperatively. All patients underwent standardized isokinetic strength testing for bilateral quadriceps and hamstrings 1 to 2 days before second-look arthroscopy. The patients were divided into 2 groups: Patients in group 1 had a ‰20% deficit on the peak torque measures for quadriceps compared with that of the contralateral knee, whereas those in group 2 had a <20% deficit on peak torque. Cartilage status at the patellofemoral joint and tibiofemoral joint were evaluated by second-look arthroscopy and the Outerbridge classification. Other assessments included the International Knee Documentation Committee (IKDC) score, Tegner and Lysholm scores, side-to-side difference on KT-2000 arthrometer, and range of motion. Results: There were 42 patients included in group 1 and 46 patients in group 2. The mean postoperative quadriceps peak torque of the involved knee compared with the contralateral knee was 70% (range, 57%-80%) in group 1 and 95% (range, 81%-116%) in group 2. For all patients, a significant worsening was seen in the patellar and trochlear cartilage (P =.030 and <.001, respectively) but not at the medial or lateral tibiofemoral joint after ACLR. A significant worsening in the status of both patellar and trochlear cartilage was seen after ACLR in group 1 (P =.013 and =.011, respectively) and of trochlear cartilage in group 2 (P =.006). Significantly fewer severe chondral lesions of the patella were found in group 2 than in group 1 (proportion of patients whose cartilage grade worsened: 26% vs 48%, P <.05; difference in cartilage grade: 0.09 vs 0.62, P <.05). There was no significant difference for trochlear chondral worsening between the 2 groups. No significant differences were detected between the 2 groups in terms of hamstring strength; Lysholm, Tegner, and IKDC scores; KT-2000 arthrometer anterior laxity; or range of motion. Conclusion: Greater than 80% recovery of quadriceps strength after ACLR is associated with less severe patellar cartilage damage at short-term follow-up. © 2015 The Author(s).

 

通讯机构:Institute of Sports Medicine of Peking, University Third Hospital, No. 49 North Garden Road, Haidian, Beijing, China
学科代码:骨科学 运动医学 整形外科学   关键词:前交叉韧带 后股四头肌 肌力 髌股关节软骨损伤 ,中国作者重要发表 爱思唯尔医学网, Elseviermed
来源: Scopus
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