目的:确定前交叉韧带(ACL)重建后参与者在神经肌肉功能和恢复运动(RTS)成功方面的潜在股四头肌与绳肌腱自体移植的差异。
方法:病例对照研究,对25名患者进行关节镜辅助手术,解剖同侧股四头肌腱移植物和两个对照组,每组25名参与者,使用半腱肌腱或半腱肌腱(腿筋)肌腱移植物ACL重建手术。两个对照组的参与者根据性别与病例组进行倾向评分匹配,年龄,Tegner活动量表以及自重建以来的康复总体积(n=25)或自重建以来的时间(n=25)。在恢复结束时(重建后平均8个月),自我报告的膝关节功能(KOOS总分),害怕在体育活动期间加载重建的膝盖(RSI-ACL问卷),和运动恐惧(运动恐惧症的坦帕量表)随后进行跳跃和跳跃测试。前跳距离(跳跃距离作为结果)之后是下降跳跃(归一化膝关节分离距离),并通过平衡正面和侧面跳跃的定性评级得出结论。组间比较采用95%置信区间比较,计算效应大小。
结果:股四头肌病例组(总是首先与康复匹配的腿筋移植物对照进行比较,其次与时间匹配的腿筋移植物对照进行比较)在体育活动中自我报告的问题不明显,只有边缘较高:Cohen\sd=0.42,d=0.44,RTS置信度较低(d=-0.30,d=-0.16),运动恐惧症较少(d=-0.25,d=0.32)。与两个腿筋对照组(d=-0.24,d=-0.35)相比,小的和更多的非显着效应大小指向前跳的股四头肌移植物组中的较低值。在股四头肌组中,归一化的膝关节分离距离没有显着意义,并且小效应的大小高于腿筋组(d=0.31,d=0.28)。
结论:在康复结束时,只有移植物间的功能结果无显著差异和边缘差异。根据结果,不建议选择腿筋或股四头肌移植物类型。决定必须单独作出。
方法:III.
OBJECTIVE: To determine potential quadriceps versus hamstring tendon autograft differences in neuromuscular function and return to sport (RTS)-success in participants after an anterior cruciate ligament (ACL) reconstruction.
METHODS: Case-control study on 25 participants operated on with an arthroscopically assisted, anatomic ipsilateral quadriceps femoris tendon graft and two control groups of 25 participants each, operated on with a semitendinosus tendon or semitendinosus-gracilis (hamstring) tendon graft ACL reconstruction. Participants of the two control groups were propensity score matched to the
case group based on sex, age, Tegner activity scale and either the total volume of rehabilitation since reconstruction (n = 25) or the time since reconstruction (n = 25). At the end of the rehabilitation (averagely 8 months post-reconstruction), self-reported knee function (KOOS sum scores), fear of loading the reconstructed knee during a sporting activity (RSI-ACL questionnaire), and fear of movement (Tampa scale of kinesiophobia) were followed by hop and jump tests. Front hops for distance (jumping distance as the outcome) were followed by Drop jumps (normalised knee joint separation distance), and concluded by qualitative ratings of the Balanced front and side hops. Between-group comparisons were undertaken using 95% confidence intervals comparisons, effect sizes were calculated.
RESULTS: The quadriceps
case group (always compared with the rehabilitation-matched hamstring graft controls first and versus time-matched hamstring graft controls second) had non-significant and only marginal higher self-reported issues during sporting activities: Cohen\'s d = 0.42, d = 0.44, lower confidence for RTS (d = - 0.30, d = - 0.16), and less kinesiophobia (d = - 0.25, d = 0.32). Small and once more non-significant effect sizes point towards lower values in the quadriceps graft groups in the Front hop for distance limb symmetry values in comparison to the two hamstring control groups (d = - 0.24, d = - 0.35). The normalised knee joint separation distance were non-significantly and small effect sized higher in the quadriceps than in the hamstring groups (d = 0.31, d = 0.28).
CONCLUSIONS: Only non-significant and marginal between-graft differences in the functional outcomes at the end of the rehabilitation occurred. The selection of either a hamstring or a quadriceps graft type cannot be recommended based on the results. The decision must be undertaken individually.
METHODS: III.