PDF(Pubmed)
Abstract：
Gait alterations after anterior cruciate ligament reconstruction (ACLR) are commonly reported and have been linked to posttraumatic osteoarthritis development. While knee gait alterations have been studied at several time points after ACLR, little is known about how these biomechanical variables change earlier than 6 months after surgery, nor is much known about how they differ over the entire stance phase of gait. The purpose of this study was to examine knee gait biomechanical variables over their entire movement pattern through stance at both 3 and 6 months after ACLR and to study the progression of interlimb asymmetry between the two postoperative time points. Thirty-five individuals underwent motion analysis during overground walking 3 (3.2 ± 0.5) and 6 (6.4 ± 0.7) months after ACLR. Knee biomechanical variables were compared between limbs and across time points through 100% of stance using statistical parametric mapping; this included a 2 × 2 (Limb × Time) repeated measures analysis of variance and two-tailed t-tests. Smaller knee joint angles, moments, extensor forces, and medial compartment forces were present in the involved versus uninvolved limb. Interlimb asymmetries were present at both time points but were less prevalent at 6 months. The uninvolved limb\'s biomechanical variables stayed relatively consistent over time, while the involved limb\'s trended toward that of the uninvolved limb. Statement of Clinical Significance: Interventions to correct asymmetrical gait patterns after ACLR may need to occur early after surgery and may need to focus on multiple parts of stance phase.
摘要：
前交叉韧带重建（ACLR）后的步态改变通常有报道，并且与创伤后骨关节炎的发展有关。虽然已经在ACLR后的几个时间点研究了膝盖步态改变，对这些生物力学变量在手术后6个月之前如何变化知之甚少，也不知道它们在步态的整个姿态阶段有什么不同。这项研究的目的是在ACLR后3个月和6个月通过姿势检查膝关节步态的生物力学变量，并研究两个术后时间点之间的肢体间不对称的进展。ACLR后3（3.2±0.5）和6（6.4±0.7）个月的地面行走期间，有35名个体进行了运动分析。使用统计参数映射，通过100％的姿势比较了四肢之间和各个时间点之间的膝关节生物力学变量；这包括2×2（肢体×时间）重复测量方差分析和双尾t检验。较小的膝关节角度，时刻,伸肌力,受累肢体和未受累肢体存在内侧隔室力。在两个时间点都存在肢体间不对称，但在6个月时不那么普遍。未涉及的肢体的生物力学变量随着时间的推移保持相对一致，而涉及的肢体倾向于未涉及的肢体。临床意义声明：ACLR后纠正不对称步态模式的干预可能需要在手术后早期进行，并且可能需要关注站立阶段的多个部分。
