Gait patterns before and after anterior cruciate ligament reconstruction
Gait patterns before and after anterior cruciate ligament reconstruction
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DOI：
10.1007/s00167-003-0440-1
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发表时间：
2004-01-01
影响因子：
3.8
通讯作者：
Kiss, RM
中科院分区：
文献类型：
--
作者：
Knoll, Z;Kocsis, L;Kiss, RM
本研究的目的是确定选择的步态参数如何因前交叉韧带（ACL）缺陷和ACL重建而改变。本研究对25名ACL缺乏的受试者进行了研究，他们分别在采用骨-髌腱-骨技术进行ACL重建手术前、术后6周、4个月、8个月和12个月。步态分析使用zebris三维超声表面肌电仪系统（zebris Medizintechnik GmbH，德国）。记录下肢的运动数据。检查的肌肉包括股外侧肌、股内侧肌、股二头肌和长内收肌。将受伤受试者的结果与51名未患前交叉韧带损伤的个体的结果进行比较。急性acl缺陷患者在手术前和手术后6周表现出股四头肌回避模式。股四头肌回避现象在慢性acl缺乏患者中没有发生。术后4个月，患者的时空参数和膝关节角度已恢复到正常步态模式。然而，术后仅8个月，相对前交叉韧带运动参数（描述胫骨向前交叉韧带方向平移）和肌电图与健康对照组相比，无显著统计学差异。结果表明：(1)股四头肌回避模式的发展比以前报道的要少，(2)前交叉韧带缺失和重建显著改变了下肢步态模式，(3)步态参数向正常值模式转移，(4)恢复损伤前的步态模式-包括正常的肌肉双相-至少需要8个月的时间。
The aim of this study is to determine how selected gait parameters may change as a result of anterior cruciate ligament (ACL) deficiency and following ACL reconstruction. The study was performed on 25 ACL-deficient subjects prior to and 6 weeks, 4 months, 8 months and 12 months after ACL reconstructive surgery by the bone-patellar tendon-bone technique. Gait analysis was performed using the zebris three-dimensional ultrasound-based system with surface electromyograph (zebris Medizintechnik GmbH, Germany). Kinematic data were recorded for the lower limb. The muscles examined include vastus lateralis and medialis, biceps femoris and adductor longus. The results obtained from the injured subjects were compared with those of 51 individuals without ACL damage. The acute ACL-deficient patients exhibited a quadriceps avoidance pattern prior to and 6 weeks after surgery. The quadriceps avoidance phenomenon does not develop in chronic ACL-deficient patients. In the individuals operated on, the spatial-temporal parameters and the knee angle had already regained a normal pattern for the ACL-deficient limb during gait 4 months after surgery. However, the relative ACL movement parameter-which describes the tibial translation into the direction of ACL-and the EMG traces show no significant statistical difference compared with the values of healthy control group just 8 months after surgery. The results suggest that: (1) development of a quadriceps avoidance pattern is less common than previously reported, (2) anterior cruciate ligament deficiency and reconstruction significantly alter the lower extremity gait pattern, (3) the gait parameters shift towards the normal value pattern, and (4) the re-establishment of pre-injury gait patterns-including the normal biphase of muscles-takes at least 8 months to occur.