Does concomitant meniscectomy or meniscal repair affect the recovery of quadriceps function post-ACL reconstruction?
Does concomitant meniscectomy or meniscal repair affect the recovery of quadriceps function post-ACL reconstruction?
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DOI：
10.1007/s00167-014-3093-3
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发表时间：
2015-09-01
影响因子：
3.8
通讯作者：
Palmieri-Smith, Riann M.
中科院分区：
文献类型：
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作者：
Lepley, Lindsey K.;Wojtys, Edward M.;Palmieri-Smith, Riann M.
本研究的目的是确定前十字韧带 (ACL) 重建后个体恢复运动时同步半月板手术对股四头肌激活和力量恢复的影响。 ACL 重建后获准参加的 46 名个体被邀请参加这项研究。根据手术报告将参与者分组（仅 ACL，n = 24；半月板修复，n = 12；半月板切除术，n = 10）。使用等速和等长测量来量化股四头肌的力量。以同心模式以 60A 度/秒收集等速强度。在膝关节弯曲 90A 度时收集等长力量。使用突发叠加技术评估股四头肌的激活，并通过中央激活比率进行量化。利用单向方差分析来检测组间股四头肌激活和强度是否存在差异。在适当的情况下，使用事后 Bonferroni 多重比较程序。股四头肌激活（P = n.s.）和力量（等速：P = n.s.；等长：P = n.s.）在各组之间没有差异。同时半月板切除或半月板修复不会影响个体在 ACL 重建后恢复运动时股四头肌激活和力量的恢复。尽管没有检测到股四头肌功能的群体差异，但所有参与者在恢复运动时都表现出股四头肌激活失败的水平低于健康个体。鉴于持续性股四头肌激活失败对膝关节功能不利，应制定针对股四头肌激活失败的康复方案并在重建后采用。
The purpose of this study was to determine the effect of concomitant meniscal surgery on the recovery of quadriceps activation and strength at a time when individuals return to sport following anterior cruciate ligament (ACL) reconstruction.Forty-six individuals that were cleared for participation following ACL reconstruction were invited to participate in this study. Participants were placed into groups according to surgical reports (ACL-only, n = 24; meniscal repair, n = 12; meniscectomy, n = 10). Quadriceps strength was quantified using isokinetic and isometric measures. Isokinetic strength was collected at 60A degrees/s in concentric mode. Isometric strength was collected at 90A degrees of knee flexion. Quadriceps activation was assessed using the burst superimposition technique and quantified via the central activation ratio. One-way ANOVAs were utilized to detect whether differences existed in quadriceps activation and strength between groups. Where appropriate, post hoc Bonferroni multiple comparison procedures were used.Quadriceps activation (P = n.s.) and strength (isokinetic: P = n.s.; isometric: P = n.s.) were not different between groups.Concomitant meniscectomy or meniscal repair did not affect the recovery of quadriceps activation and strength at a time when individuals return to sport following ACL reconstruction. Though group differences in quadriceps function were not detected, all participants demonstrated levels of quadriceps activation failure that are below healthy individuals at a time when they were returned to sport. Given that persistent quadriceps activation failure is detrimental to knee function, rehabilitation protocols that target quadriceps activation failure should be developed and employed post-reconstruction.III.