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Abstract：
UNASSIGNED: Femoral nerve block (FNB) and adductor canal block (ACB) have been used increasingly for pain control during anterior cruciate ligament (ACL) reconstruction in adolescent patients. However, recent evidence suggests that the use of FNB may affect quadriceps strength recovery 6 months after surgery.
UNASSIGNED: To compare postoperative isokinetic strength in adolescents who received FNB, ACB, or no block for perioperative analgesia during ACL reconstruction. We anticipated lower postoperative quadriceps and hamstring isokinetic deficits in adolescents who received FNB as compared with ACB.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: Patients were included in the study if they had undergone hamstring tendon autograft ACL reconstruction by a single surgeon from July 2008 to January 2018 and if they underwent isokinetic muscle testing at 4 to 8 months postoperatively. The participants were divided into 3 groups (no block, FNB, and ACB), and we compared the deficit in percentages between the affected and unaffected limbs as calculated from the isokinetic quadriceps and hamstring strength testing at 60 and 180 deg/s. Between-group analysis was performed using analysis of variance, with an alpha of .05.
UNASSIGNED: A total of 98 participants were included in the analysis (31 no block, 36 FNB, and 31 ACB). The mean ± SD age of the patients was 15.26 ± 1.15, 15.50 ± 1.42, and 15.71 ± 1.44, for no block, FNB, and ACB, respectively. At 5.61 months postoperatively, there was no significant difference across the 3 groups in isokinetic quadriceps deficits (P ≥ .99), and the only significant difference in isokinetic hamstring deficit was observed for peak flexion at 180 deg/s, in which the ACB group had lower peak torque than the FNB group (-9.80% ± 3.48% vs 2.37% ± 3.23%; P = .035). The ratio of participants with a deficit exceeding 15% did not differ significantly among the 3 groups.
UNASSIGNED: Contrary to previous research, our findings indicate only minimal difference in quadriceps strength among the 3 types of perioperative analgesia in adolescents approximately 6 months after ACL reconstruction. The only significant strength deficit was seen in the hamstrings of patients receiving ACB at peak flexion as compared with those receiving FNB.
UNASSIGNED: To compare postoperative isokinetic strength in adolescents who received FNB, ACB, or no block for perioperative analgesia during ACL reconstruction. We anticipated lower postoperative quadriceps and hamstring isokinetic deficits in adolescents who received FNB as compared with ACB.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: Patients were included in the study if they had undergone hamstring tendon autograft ACL reconstruction by a single surgeon from July 2008 to January 2018 and if they underwent isokinetic muscle testing at 4 to 8 months postoperatively. The participants were divided into 3 groups (no block, FNB, and ACB), and we compared the deficit in percentages between the affected and unaffected limbs as calculated from the isokinetic quadriceps and hamstring strength testing at 60 and 180 deg/s. Between-group analysis was performed using analysis of variance, with an alpha of .05.
UNASSIGNED: A total of 98 participants were included in the analysis (31 no block, 36 FNB, and 31 ACB). The mean ± SD age of the patients was 15.26 ± 1.15, 15.50 ± 1.42, and 15.71 ± 1.44, for no block, FNB, and ACB, respectively. At 5.61 months postoperatively, there was no significant difference across the 3 groups in isokinetic quadriceps deficits (P ≥ .99), and the only significant difference in isokinetic hamstring deficit was observed for peak flexion at 180 deg/s, in which the ACB group had lower peak torque than the FNB group (-9.80% ± 3.48% vs 2.37% ± 3.23%; P = .035). The ratio of participants with a deficit exceeding 15% did not differ significantly among the 3 groups.
UNASSIGNED: Contrary to previous research, our findings indicate only minimal difference in quadriceps strength among the 3 types of perioperative analgesia in adolescents approximately 6 months after ACL reconstruction. The only significant strength deficit was seen in the hamstrings of patients receiving ACB at peak flexion as compared with those receiving FNB.
摘要：
■股神经阻滞（FNB）和内收肌管阻滞（ACB）已越来越多地用于青少年患者前交叉韧带（ACL）重建过程中的疼痛控制。然而,最近的证据表明，使用FNB可能会影响四头肌术后6个月的力量恢复。
■为了比较接受FNB的青少年术后等速肌力，ACB,或在ACL重建期间未阻断围手术期镇痛。与ACB相比，我们预计接受FNB的青少年术后股四头肌和腿筋等速肌缺陷较低。
■队列研究；证据水平，3.
如果患者在2008年7月至2018年1月期间由一名外科医生进行了绳肌腱自体ACL重建，并且在术后4至8个月进行了等速肌测试，则将其纳入研究。参与者被分为3组(没有阻塞，FNB,和ACB），我们比较了在60和180°/s时通过等速股四头肌和腿筋强度测试计算的受影响肢体和未受影响肢体之间的百分比。组间分析采用方差分析，阿尔法为0.05。
■总共98名参与者被纳入分析（31个无区块，36FNB,和31ACB）。患者的平均±SD年龄分别为15.26±1.15、15.50±1.42和15.71±1.44，FNB,ACB,分别。术后5.61个月，3组的等速四头肌缺陷无显著差异(P≥.99),在180°/s的屈曲峰值时，观察到等速腿筋缺损的唯一显着差异，其中ACB组的峰值扭矩低于FNB组(-9.80%±3.48%vs2.37%±3.23%;P=0.035)。赤字超过15％的参与者的比例在3组中没有显着差异。
■与以往的研究相反，我们的研究结果表明,在ACL重建后约6个月的青少年围手术期镇痛中,3种类型的股四头肌强度差异极小.与接受FNB的患者相比，在最大屈曲时接受ACB的患者的腿筋中唯一明显的力量不足。
■为了比较接受FNB的青少年术后等速肌力，ACB,或在ACL重建期间未阻断围手术期镇痛。与ACB相比，我们预计接受FNB的青少年术后股四头肌和腿筋等速肌缺陷较低。
■队列研究；证据水平，3.
如果患者在2008年7月至2018年1月期间由一名外科医生进行了绳肌腱自体ACL重建，并且在术后4至8个月进行了等速肌测试，则将其纳入研究。参与者被分为3组(没有阻塞，FNB,和ACB），我们比较了在60和180°/s时通过等速股四头肌和腿筋强度测试计算的受影响肢体和未受影响肢体之间的百分比。组间分析采用方差分析，阿尔法为0.05。
■总共98名参与者被纳入分析（31个无区块，36FNB,和31ACB）。患者的平均±SD年龄分别为15.26±1.15、15.50±1.42和15.71±1.44，FNB,ACB,分别。术后5.61个月，3组的等速四头肌缺陷无显著差异(P≥.99),在180°/s的屈曲峰值时，观察到等速腿筋缺损的唯一显着差异，其中ACB组的峰值扭矩低于FNB组(-9.80%±3.48%vs2.37%±3.23%;P=0.035)。赤字超过15％的参与者的比例在3组中没有显着差异。
■与以往的研究相反，我们的研究结果表明,在ACL重建后约6个月的青少年围手术期镇痛中,3种类型的股四头肌强度差异极小.与接受FNB的患者相比，在最大屈曲时接受ACB的患者的腿筋中唯一明显的力量不足。
