Knee joint mechanics during gait after anterior cruciate ligament reconstruction using a partial or full thickness quadriceps tendon autograft at 2 years after surgery.

IF 2.2 4区医学 Q1 REHABILITATION

PM&R Pub Date : 2024-11-16 DOI:10.1002/pmrj.13278

Zachary Ripic, Michael Letter, Rosalia Parrino, William Adams, Lee D Kaplan, Michael G Baraga, Thomas M Best, Joseph F Signorile, Moataz Eltoukhy

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引用次数: 0

Abstract

Background: Despite quadriceps weakness in individuals after quadriceps tendon anterior cruciate ligament reconstruction (QT-ACLR), and its association with knee joint mechanics, no studies have addressed gait mechanics in both partial-thickness (PT-Q) and full-thickness (FT-Q) options for QT-ACLR.

Objective: To assess gait mechanics across a QT-ACLR cohort. We hypothesized that QT-ACLR would show changes in knee joint mechanics compared to control participants (CON) and nonoperated limbs. Additionally, we hypothesized that FT-Q operated limbs would show greater changes compared to PT-Q and CON.

Design: Retrospective cohort study.

Setting: University-affiliated sports medicine institute.

Participants: Sixteen patients who underwent QT-ACLR (7 FT-Q: Age (years) = 28.6 ± 7.3, post-op (months) = 23.5 ± 10.7, 9 PT-Q: Age = 25.2 ± 4.3, post-op = 24.4 ± 11.7) were recruited and compared to 11 CON (age = 23.4 ± 4.8).

Intervention: Participants underwent gait testing with force plate integrated motion capture.

Main outcome measures: Mixed repeated-measures analyses of covariance, adjusted for gait speed, were used to determine significant main effects or interactions in peak knee flexion angle, sagittal knee range of motion, peak internal knee extension moment (KEM), and peak internal knee flexion moment.

Results: When measured an average of 2 years after surgery, no main effect for limb or limb by depth interaction were detected. A significant effect by group was observed for peak KEM (p = .03, η² = .27) and peak knee flexion angle (p = .04, η² = .24) in the loading response phase. FT-Q (p = .02) and PT-Q (p = .03) showed lower KEM compared to the CON group in both limbs. The FT-Q group showed lower peak knee flexion angle compared to the CON group (p = .01).

Conclusions: Knee joint symmetry may be recovered 2 years following QT-ACLR, but lower KEM compared to CON for both graft options and lower peak knee flexion angle than CON for the FT-Q group may indicate a need for further investigation in QT-ACLR.

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使用部分或全厚股四头肌肌腱自体移植进行前交叉韧带重建术后两年步态时的膝关节力学。

背景：尽管股四头肌腱前交叉韧带重建术（QT-ACLR）后的患者会出现股四头肌无力的情况，而且这种情况与膝关节力学有关，但目前还没有研究对部分厚度（PT-Q）和全厚度（FT-Q）QT-ACLR方案的步态力学进行研究：评估 QT-ACLR 组群的步态力学。我们假设，与对照组参与者（CON）和非手术肢体相比，QT-ACLR 将显示膝关节力学的变化。此外，我们还假设，与 PT-Q 和 CON 相比，FT-Q 手术肢体将显示出更大的变化：设计：回顾性队列研究：地点：大学附属运动医学研究所：16 名接受 QT-ACLR 的患者（7 名接受 FT-Q：年龄（岁）= 28.6 ± 7.3，术后（月）= 23.5 ± 10.7，9 PT-Q：年龄 = 25.2 ± 4.3，术后 = 24.4 ± 11.7），并与 11 名 CON（年龄 = 23.4 ± 4.8）进行了比较：主要结果测量：混合重复测量协方差分析（根据步速进行调整）用于确定膝关节屈曲角度峰值、膝关节矢状运动范围、膝关节内伸力矩峰值（KEM）和膝关节内屈力矩峰值的显著主效应或交互作用：结果：在术后平均 2 年进行测量时，未发现肢体的主效应或肢体与深度的交互作用。在加载反应阶段，KEM峰值（p = .03，η2 = .27）和膝关节屈曲角度峰值（p = .04，η2 = .24）对组别有明显影响。与 CON 组相比，FT-Q 组（p = 0.02）和 PT-Q 组（p = 0.03）两肢的 KEM 均较低。与 CON 组相比，FT-Q 组的膝关节屈曲角度峰值较低（p = .01）：结论：QT-ACLR术后2年，膝关节对称性可能得到恢复，但两种移植方案的KEM均低于CON组，FT-Q组的膝关节屈曲角度峰值低于CON组，这可能表明QT-ACLR需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PM&R REHABILITATION-SPORT SCIENCES

CiteScore

4.30

自引率

4.80%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.