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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Return-to-Sport Testing After Medial Patellofemoral Ligament Reconstruction in Adolescent Athletes
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Return-to-Sport Testing After Medial Patellofemoral Ligament Reconstruction in Adolescent Athletes

机译：青少年运动员Pat股韧带内侧重建后的运动恢复测试

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Background: Return to sport (RTS) after patellar stabilization surgery involves the return of strength and dynamic knee stability, which can be assessed using isometric strength and functional performance testing. Purpose: To investigate the results of isometric strength and functional RTS testing between the surgical and uninvolved limbs in adolescent patients who underwent medial patellofemoral ligament (MPFL) reconstruction for patellar instability. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of adolescent patients who underwent MPFL reconstruction identified 28 patients (20 female, 8 male) who also underwent isometric and functional RTS testing. Data were compared with the uninvolved limb. The recovery of muscle strength was defined by a limb symmetry index (LSI) ≥90%. Differences in peak torque were compared using the Wilcoxon signed-rank test. Correlations were examined between dependent and independent variables using the Spearman correlation. Results: The mean age of the patients was 14.9 years (range, 12-16 years). Reconstruction was performed with a hamstring autograft in 17 (60.7%) patients. Concomitant tibial tubercle osteotomy was performed in 10 (35.7%) patients. Testing was performed at a mean 7.4 months (range, 5.5-11.9 months) postoperatively. The mean LSIs for quadriceps and hamstring strength were 85.3% and 95.1%, respectively. For knee extension, there was a statistically significant difference between isometric peak torque measured in the surgical and uninvolved limbs ( P = .001). Only 32.0% of patients passed all 4 hop tests. Also, 63.0% of patients achieved an anterior reach asymmetry of &4 cm on the Lower Quarter Y-Balance Test (YBT-LQ). There were no statistically significant differences in isometric strength testing, hop tests, or the YBT-LQ based on graft type or concomitant procedures. There was no correlation between isometric strength and performance on the YBT-LQ or hop tests. Conclusion: Adolescent athletes undergoing MPFL reconstruction may need prolonged rehabilitation programs beyond 8 months to allow the adequate recovery of muscle strength for safe RTS. There is a significant deficit in isometric quadriceps strength in the surgical limb after surgery. Further investigation is needed to determine safe RTS criteria after MPFL reconstruction in the pediatric and adolescent population.
机译：背景：pa骨稳定手术后恢复运动（RTS）涉及强度和动态膝关节稳定性的恢复，这可以使用等距强度和功能性能测试进行评估。目的：研究接受media股内侧韧带（MPFL）重建治疗pa骨不稳的青春期患者，手术和未受累肢体之间的等距强度和功能性RTS测试的结果。研究设计：案例系列;证据等级，4。方法：回顾性回顾了接受MPFL重建的青春期患者，发现28例患者（20例女性，8例男性）也接受了等距和功能性RTS测试。将数据与未受累肢体进行比较。肢体对称指数（LSI）≥90％定义了肌肉力量的恢复。使用Wilcoxon符号秩检验比较峰值扭矩的差异。使用Spearman相关性检查因变量和自变量之间的相关性。结果：患者的平均年龄为14.9岁（范围：16-16岁）。 17例（60.7％）患者使用a绳肌自体移植重建。 10例（35.7％）患者同时行胫骨结核截骨术。术后平均7.4个月（范围5.5-11.9个月）进行测试。股四头肌和绳肌力量的平均LSI分别为85.3％和95.1％。对于膝关节伸展，在手术和未受累肢体中测得的等距峰值扭矩之间存在统计学上的显着差异（P = .001）。只有32.0％的患者通过了全部4次跳跃测试。同样，在下四分之一的Y平衡测试（YBT-LQ）上，有63.0％的患者达到了小于4 cm的前伸不对称性。在基于移植物类型或伴随程序的等距强度测试，跳跃测试或YBT-LQ中，在统计学上没有显着差异。在YBT-LQ或跳跃测试中，等距强度与性能之间没有相关性。结论：正在进行MPFL重建的青春期运动员可能需要将康复计划延长至8个月以上，以使肌肉力量得到适当恢复，从而获得安全的RTS。手术后四肢的四头肌等距力量明显不足。小儿和青少年人群进行MPFL重建后，需要进一步研究以确定安全的RTS标准。

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