Abstract:
The study aimed to determine differences in sagittal-plane joint biomechanics between athletes with and without knee osteoarthritis (OA) during drop vertical jump 2 years after anterior cruciate ligament reconstruction (ACLR). Forty-one athletes with ACLR completed motion analysis testing during drop vertical jump from 30 cm. Sagittal-plane peak joint angles and moments and joint contributions to total support moment (TSM) were calculated during first landing. Medial compartment knee OA of the reconstructed knee was evaluated using Kellgren-Lawrence scores (ACLR group: Kellgren-Lawrence <2; ACLR-OA group: Kellgren-Lawrence ≥2). The ACLR-OA group (n = 13) had higher hip and lower knee contributions in the surgical limb than the ACLR group and their nonsurgical limb. Further, the ACLR-OA group had higher peak hip extension moment than the ACLR group (P = .024). The ACLR-OA group had significantly lower peak knee extension and ankle plantar flexion moments and TSM (P ≤ .032) than ACLR group. The ACLR-OA group landed with increased hip extension moment, decreased knee extension and ankle plantar flexion moments and TSM, and decreased knee and increased hip contributions to TSM compared with ACLR group. The ACLR-OA group may have adopted movement patterns to decrease knee load and compensated by shifting the load to the hip. Clinicians may incorporate tailored rehabilitation programs that mitigate the decreased knee load to minimize the risk of knee OA after ACLR.
摘要:
该研究旨在确定前交叉韧带重建(ACLR)后2年垂直跳伞时,有和没有膝关节骨关节炎(OA)的运动员在矢状平面关节生物力学方面的差异。41名具有ACLR的运动员在从30厘米垂直跳下时完成了运动分析测试。在首次着陆期间,计算了矢状平面峰值关节角度和力矩以及关节对总支撑力矩(TSM)的贡献。使用Kellgren-Lawrence评分评估重建膝关节的内侧室膝关节OA(ACLR组:Kellgren-Lawrence<2;ACLR-OA组:Kellgren-Lawrence≥2)。ACLR-OA组(n=13)在手术肢体中的髋关节和下膝关节贡献高于ACLR组及其非手术肢体。Further,ACLR-OA组比ACLR组有更高的峰值髋关节伸展力矩(P=0.024).与ACLR组相比,ACLR-OA组的峰值膝关节伸展和踝关节足屈力矩和TSM(P≤.032)明显较低。ACLR-OA组落地时髋部伸展力矩增加,膝关节伸展和踝关节足底屈曲力矩和TSM减少,与ACLR组相比,膝关节减少,髋关节对TSM的贡献增加。ACLR-OA组可能采用运动模式来减少膝盖负荷,并通过将负荷转移到髋部来补偿。临床医生可能会纳入量身定制的康复计划,以减轻膝关节负荷的降低,以最大程度地降低ACLR后膝关节OA的风险。