acl重建后胫骨旋转强度缺陷:腘绳肌与自体髌腱移植

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

斯蒂德曼·菲利蓬研究所，韦尔，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)， 21%使用(内侧)腘绳肌腱签名进行初步重建2。本研究的目的是确定胫骨内旋转(ITR)和胫骨外旋转(ETR)在腘绳肌腱和BTB重建患者之间的峰值扭矩差异。患者入选标准:= 1年。手术后，对侧膝盖恢复正常。46例患者，23例(男性16例，女性7例)接受自体BTB移植，23例(男性9例:女性14例)接受自体腘绳肌腱移植重建，放置于Cybex上，平卧位，髋关节为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种等速(60、120、180°/秒)下取其平均值。相对的ITR和ETR峰值扭矩缺陷通过从未受累肢体的评分中减去受累肢体的绝对评分来计算。组间，相对ITR和ETR峰值扭矩缺陷采用非配对t检验进行比较(p = 0.05)。结果显示，腘绳肌腱组的相对ITR峰值扭矩亏损分别为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}