采用腘绳肌腱重建前交叉韧带后，青少年股四头肌肌力恢复快于成人。

IF 2.7 Q1 ORTHOPEDICS

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2025-05-11 DOI:10.1016/j.jisako.2025.100901

Marc Dauty , Loïc Geffroy , Antoine Chalopin , Pierre Menu , Jérôme Grondin , Thomas Hirardot , Vincent Crenn , Alban Fouasson-Chailloux

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引用次数: 0

摘要

目的：前交叉韧带重建后的膝关节肌力恢复通常使用等速肢体对称指数来评估，以帮助决定是否允许恢复先前的运动。然而，年龄对膝关节力量恢复的作用尚不清楚。因此，我们的目的是比较4个月和7个月时不同年龄的前交叉韧带移植重建术后膝关节肌力的等速恢复。方法：从2018-2023年的历史队列中选取腘绳肌腱移植重建前交叉韧带后4个月和7个月完成等速监测的患者，根据年龄≤19岁和bb0 -20岁两组进行比较。以股四头肌和腘绳肌肢体对称指数为主要指标进行研究。通过多变量分析来评估膝关节力量演变中潜在的主体间解释参数的权重。结果：253名青少年与247名成年人进行了比较。在随访4个月和7个月时，60°/s时青少年股四头肌对称指数显著高于成年人（分别为79%对72%，88%对82%）。腘绳肌对称指数差异无统计学意义。多变量分析后未发现受试者间的解释参数。结论：采用腘绳肌腱重建前交叉韧带后，青少年膝关节力量恢复速度快于成人。这个结果应该仔细考虑，因为青少年可能过早地恢复运动，而如果只考虑力量切断，移植物破裂的风险仍然很高。证据等级：III。

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Quadriceps muscle strength of adolescents recovers faster than those of adults after anterior cruciate ligament reconstruction using hamstring graft

Objectives

Knee muscle strength recovery after anterior cruciate ligament reconstruction is usually evaluated using isokinetic limb symmetry index to help take the decision to allow return to the previous sport. However, the role of age on knee strength recovery is not well known. So, we aimed to compare the isokinetic knee muscle strength recovery according to age at 4 and 7 months after anterior cruciate ligament reconstruction using hamstring graft.

Methods

From a historical cohort (2018-2023) of patients who completed isokinetic monitoring at 4 and 7 months after anterior cruciate ligament reconstruction using hamstring graft, two groups were compared according to age: ≤19 and > 20 years old. The quadriceps and hamstring limb symmetry indexes were studied as the main parameters. A multivariate analysis was realized to assess the weight of potential inter-subject explanatory parameters on knee strength evolution.

Results

Two hundred fifty-three adolescents were compared with 247 adults. The adolescent quadriceps symmetry index at 60°/s was significantly higher than that of adults (79% vs 72% and 88% vs 82% at 4 and 7 months of follow-up, respectively). The hamstring symmetry index was not statistically significantly different. No inter-subject explanatory parameters were found after the multivariate analysis.

Conclusion

Knee strength recovers faster in adolescents than in adults after anterior cruciate ligament reconstruction using hamstring graft. This result should be carefully considered because adolescents could be exposed to return to sport too early, while the risk of graft rupture is still high, if strength cutoff is only considered.