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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Effect of ACL Graft Type on Side-Step Cutting in Young Athletes
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Effect of ACL Graft Type on Side-Step Cutting in Young Athletes

机译：ACL接枝类型对年轻运动员分步切割的影响

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Objectives: Due to the slightly higher re-tear rate for ACL reconstruction (ACLR) with hamstring (HT) versus patellar tendon (PT), differences in movement strategies were assessed during side-step cutting in young athletes with recent ACLR to determine if graft type affected post-operative motion. Methods: Dominant limbs from 21 athletes without lower extremity injury or previous surgery (age 14.9 ± 2.0 years) and 26 limbs with recent (5.1-8.0 months post-operative) unilateral ACLR were included, 18 with HT grafts (age 16.6 ± 3.7 years) and 8 with PT (age 16.7 ± 1.2 years). Lower extremity 3-dimensional data was recorded during the deceleration phase (initial contact to maximum knee flexion) of a 45° cut. Group differences were assessed using analysis of variance with Bonferroni post-hoc tests. Results: The HT group had a slower approach velocity than controls (2.9 vs. 3.5 m/s; p=0.006) with intermediate velocity in the PT group (3.2 m/s). Both the HT and PT groups had lower peak ground reaction force (GRF) compared to controls (HT: 2.0 body weights, PT: 2.2 BW, Control: 2.8 BW; p≤0.02), along with lower peak knee flexion moments (HT: 1.4 Nm/kg, PT: 1.3 Nm/kg, Control: 2.2 Nm/kg; p=0.002). The PT group had less power absorption at the knee than controls (0.3 vs. 0.7 Nm/kg; p=0.07), while the HT group had more at the hip (0.4 vs. 0.1 Nm/kg; p=0.04). The HT group also had higher peak hip flexion (HT: 65.8°, PT: 53.9°, Control: 55.1°; p≤0.06) and hip sagittal plane excursion (HT: 9.4°, PT: 3.6°, Control: 2.8°; p≤0.05) than the PT and control groups. The HT group had lower peak knee valgus moments than controls (0.05 vs. 1.2 Nm/kg; p=0.01) as well as a greater range of frontal plane pelvic (8.2° vs. 3.4°; p=0.03) and hip (7.6° vs. 3.0°; p=0.05) motion. The PT group had intermediate values for valgus moment (0.8 Nm/kg) and pelvic (4.9°) and hip (3.3°) excursion. Conclusion: While both ACLR groups showed reduced GRFs and knee flexion moments compared with controls, the HT group demonstrated greater adaptations proximally with increased hip flexion and frontal plane pelvic and hip excursion. The lower frontal and sagittal plane hip motion in the PT group may be due to anterior knee pain associated with PT grafts. Since the HT group exhibited movement adaptations, but no observable pathologic movement patterns, such as increased knee valgus moment, other factors likely account for the observed higher re-tear rate in HT vs. PT ACLR.
机译：目的：由于绳肌（HT）与pa肌腱（PT）的ACL重建（ACLR）的再撕裂率略高，因此，对于近期ACLR的年轻运动员，在侧步切割期间评估了运动策略的差异，以确定是否进行了移植类型影响术后运动。方法：纳入21名无下肢损伤或先前手术（14.9±2.0岁）的运动员的主要肢体，以及26例近期（术后5.1-8.0个月）单侧ACLR的肢体，其中18例采用HT移植物（16.6±3.7岁） ）和PT（年龄16.7±1.2岁）为8。在45°切口的减速阶段（初次接触到最大膝盖屈曲）期间记录下肢3维数据。组差异通过Bonferroni事后检验进行方差分析进行评估。结果：HT组的进场速度比对照组慢（2.9 vs. 3.5 m / s; p = 0.006），而PT组的进场速度中等（3.2 m / s）。与对照组相比（HT：2.0体重，PT：2.2 BW，对照组：2.8 BW;p≤0.02），HT和PT组均具有较低的峰值地面反作用力（GRF），以及较低的膝盖屈曲峰值（HT： 1.4 Nm / kg，PT：1.3 Nm / kg，对照：2.2 Nm / kg; p = 0.002）。 PT组膝关节的吸收功率比对照组少（0.3 vs. 0.7 Nm / kg; p = 0.07），而HT组髋关节的吸收更多（0.4 vs. 0.1 Nm / kg; p = 0.04）。 HT组也有较高的峰值髋屈曲（HT：65.8°，PT：53.9°，对照：55.1°;p≤0.06）和臀部矢状面偏移（HT：9.4°，PT：3.6°，对照：2.8°; p≤0.05）。 HT组膝外翻峰值力矩低于对照组（0.05 vs. 1.2 Nm / kg; p = 0.01），额叶骨盆的范围更大（8.2°vs. 3.4°; p = 0.03）和臀部（7.6）相对于3.0°; p = 0.05）运动。 PT组的外翻力矩（0.8 Nm / kg）和骨盆（4.9°）和臀部（3.3°）偏移为中间值。结论：虽然ACLR组与对照组相比均显示GRF和膝关节屈曲力矩降低，但HT组在近端适应性更强，髋关节屈曲增加，额骨盆和髋骨偏移。 PT组下额和矢状平面髋关节运动较慢可能是由于PT移植物引起的前膝关节疼痛。由于HT组表现出运动适应性，但没有可观察到的病理运动模式，例如膝外翻力矩增加，因此其他因素可能是HT与PT ACLR相比观察到的较高的后退率。

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