前交叉韧带重建后胫骨旋转强度不足:腘绳肌vs自体髌腱

J. Dorris, mr . Torry, D. Newfield, M.J. Decker, R. Viola, J.R. Steadman

SteadmanPhilippon研究所，Vail, CO

在美国，每年大约有50,000例ACL重建手术。虽然许多(76%)外科医生使用骨-髌骨肌腱-骨(BTB)，但21%的外科医生使用(内侧)腘绳肌签名进行初次重建2。本研究的目的是确定腘绳肌和BTB重建患者的胫骨内旋转(ITR)和胫骨外旋转(ETR)峰值扭矩差异。患者入选标准为:= 1年。手术后，对侧膝盖正常。46例患者，其中23例(男性16例，女性7例)采用BTB自体移植物，23例(男性9例，女性14例)采用腘绳肌腱自体移植物重建，取仰卧位，髋60°，膝关节和踝关节屈曲90°。记录了5个最大、同心、ITR和ETR峰值扭矩值，并在3个等速(60、120、180°/秒)中取平均值。相对的ITR和ETR峰值扭矩缺陷是用受累肢体的绝对评分减去未受累肢体的评分来计算的。两组间，采用非配对t检验比较相对ITR和ETR峰值扭矩缺陷(p = 0.05)。结果显示，腘绳肌组的相对ITR峰值扭矩缺陷分别为2.6、3.0和3.2英尺/磅。 at angular velocities of 60, 120, and 180°/sec. The relative ITR peak torque of BTB group were 0.7, 0.3, and 0.4 foot/lbs. There were significant differences between the magnitudes of relative ITR peak torque deficits at all speeds (p = 0.02). The relative ETR peak torque deficits of the hamstring group were -0.7, 0.0, and -0.7 foot/lbs. at speeds of 60, 120, and 180° /sec. The relative ETR peak torque deficits of the BTB group were 2.4, 2.1, and 1.6 foot/lbs. There were significant differences between the magnitudes of the ETR peak torque deficits between groups at all speeds (p = 0.01). The type of ACL reconstruction surgery has a residual effect on the ability to generate ITR and ETR peak torque. {1Johnson, AJKS, 44:391-406, 1995; 2Campbell, AJKS, 11:2:1-8, 1998}