Multiaxis muscle strength in ACL deficient and reconstructed knees: compensatory mechanism.
Multiaxis muscle strength in ACL deficient and reconstructed knees: compensatory mechanism.
复制标题
ACL 缺陷和重建膝盖的多轴肌肉力量：补偿机制。
DOI：
10.1097/00005768-200201000-00002
复制
发表时间：
2002
影响因子：
4.1
通讯作者：
Butler,JesseP
中科院分区：
文献类型：
--
作者：
Zhang,Li-Qun;Nuber,GordonW;Bowen,MarkK;Koh,JasonL;Butler,JesseP
目的前交叉韧带（ACL）损伤及重建后胫骨旋转和膝关节外展肌力的变化尚不清楚。考虑到ACL的倾斜方向以及ACL在各种胫骨旋转和内收位置提供的限制，这种强度变化是可能的。本研究的目的是评估ACL缺陷和重建膝关节的多轴肌肉力量，并深入了解潜在的补偿机制所采用的patients.MethodsMuscle力量在胫骨内外旋，外展-内收，屈曲-伸展进行了调查，在19个慢性ACL缺陷，18个急性ACL缺陷，21 ACL重建，和23名正常人。结果慢性前交叉韧带损伤患者的内旋/外旋强度比明显低于正常对照组和急性前交叉韧带损伤患者（P= 0.02），表明患者形成了一种代偿机制，以卸载ACL和/或避免膝关节位置不稳定。对于ACL重建患者，内/外旋强度比变得更接近于正常对照组，而不是慢性ACL缺陷患者，这可能反映了重建后补偿需求的减少。此外，在膝关节伸展，减少胫骨旋转和外展强度减少相比，ACL重建后不太严重，更容易recovery.ConclusionA更好地了解多轴肌肉力量的变化和相关的补偿机制，将有助于我们更准确地评估治疗结果，并制定更有效的治疗模式，重点是肌肉，帮助保护和卸载ACL。
PurposeIt is unclear how muscle strength in tibial rotation and knee abduction change following anterior cruciate ligament (ACL) injury and reconstruction. Such strength changes are likely, considering the oblique orientation of the ACL and the constraint provided by the ACL at various tibial rotation and adduction positions. The purposes of this study were to evaluate multiaxis muscle strength in ACL deficient and reconstructed knees and to gain insights into potential compensatory mechanisms adopted by the patients.MethodsMuscle strength in tibial internal-external rotation, abduction-adduction, and flexion-extension were investigated in 19 chronic ACL deficient, 18 acute ACL deficient, 21 ACL reconstructed, and 23 normal subjects. The strength ratios of flexion/extension, abduction/adduction, and internal/external rotation were determined for each subject and compared across the different populations.ResultsThe chronic ACL deficient patients showed significantly lower strength ratio in internal/external rotation than that of the normal controls and acute ACL deficient subjects (P= 0.02), indicating a compensatory mechanism developed by the patients to unload the ACL and/or to avoid unstable knee positions. For ACL reconstructed patients, the internal/external rotation strength ratio became closer to their counterparts in normal controls than that of chronic ACL deficient patients, presumably reflecting the reduced need for compensation after reconstruction. Furthermore, compared with strength reduction in knee extension, reductions in tibial rotation and abduction strength following ACL reconstruction were less severe and more easy to recover.ConclusionA better understanding of changes in multiaxis muscle strength and the associated compensatory mechanism will help us evaluate treatment outcome more accurately and develop more effective treatment modalities with focus on muscles that help protect and unload the ACL.