Gait mechanics 2 years after anterior cruciate ligament reconstruction are associated with longer-term changes in patient-reported outcomes.

Gait mechanics 2 years after anterior cruciate ligament reconstruction are associated with longer-term changes in patient-reported outcomes.
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DOI:
10.1002/jor.23317
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发表时间:
2017-03
期刊:
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
影响因子:
--
通讯作者:
Andriacchi TP
Andriacchi TP
中科院分区:
其他
文献类型:
--
作者:
Erhart-Hledik JC;Chu CR;Asay JL;Andriacchi TP

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这项研究验证了这样一个假设,即前交叉韧带(ACL)重建2年后膝关节步态力学的侧向差异与患者报告的结果评分的长期变化(重建后约8年)相关。对16例单侧前交叉韧带重建患者(男性5例,年龄29.1±7.1岁)进行基线步态测试(重建后2.2±0.3年),并填写Koos和Lysholm调查问卷。在长期随访时(前交叉韧带重建后7.7±0.7年),相同的受试者完成Koos和Lysholm调查。皮尔逊相关系数评估了基线时两侧运动学和动力学差异与前交叉韧带重建后2-8年Lysholm和Koos疼痛/生活质量评分变化之间的关系。在基线时,前交叉韧带重建膝关节与对侧膝关节相比,平均内翻旋转较大(−:r=0.654,p=0.006)和股骨前移量(Lysholm:r=0.578,p=0.019)较小,且随访结果评分较差。最大屈膝力矩(Koos疼痛:r=−0.572,p=0.026;Koos生活质量:r=−0.636,p=0.011)、最大膝关节内收力矩(Lysholm:r=−0.582,p=0.018;Koos疼痛:r=−0.742,p=0.002;Koos生活质量:r=−0.551,p=0.033)与最大内旋力矩(Lysholm:r=0.525,p=0.037;Koos疼痛:r=0.815,p<0.033;Koos生活质量:r=0.777,p=0.001),随访结果较差的前交叉韧带重建膝关节。这项研究的结果支持这样的假设,即前交叉韧带重建后步态力学的早期变化与患者报告的结果的长期临床变化相关,提示最早在前交叉韧带重建后2年获得的生物力学标记物可能有助于了解这一人群的临床结果。
This study tested the hypothesis that side-to-side differences in knee gait mechanics 2 years after anterior cruciate ligament (ACL) reconstruction are associated with long-term (~8 years post-reconstruction) changes in patient-reported outcome scores. Sixteen subjects (5 males; age: 29.1 ± 7.1 years) with primary unilateral ACL reconstruction were gait tested at baseline (2.2 ± 0.3 years post-ACL reconstruction) and filled out KOOS and Lysholm surveys. At long-term follow-up (7.7 ± 0.7 years post-ACL reconstruction), the same subjects completed KOOS and Lysholm surveys. Pearson correlation coefficients assessed relationships between side-to-side differences in kinematics and kinetics at baseline and changes in Lysholm and KOOS Pain/QOL scores from 2 to 8 years post-ACL reconstruction. Significant associations were seen between greater average varus rotation (Lysholm: R =−0.654, p =0.006) and less anterior femoral displacement (Lysholm: R =0.578, p =0.019) during stance of the ACL reconstructed knee versus the contralateral knee at baseline and worse follow-up outcome scores. Significant associations were seen between greater peak knee flexion moment (KOOS Pain: R =−0.572, p =0.026; KOOS QOL: R =−0.636, p =0.011), peak knee adduction moment (Lysholm: R =−0.582, p =0.018; KOOS Pain: R =−0.742, p =0.002; KOOS QOL: R =−0.551, p =0.033), and peak internal rotation moment (Lysholm: R =0.525, p =0.037; KOOS Pain: R =0.815, p <0.001; KOOS QOL: R =0.777, p =0.001) in the ACL reconstructed knee at baseline with worse follow-up outcomes. The results of this study support the hypotheses that early changes in gait mechanics following ACL reconstruction are associated with longer-term clinical changes in patient-reported outcomes, suggesting that biomechanical markers obtained as early as 2 years after ACL reconstruction may be useful to understand clinical outcomes in this population.
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发表时间: 2014-11
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