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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >An Ecological Study of Anterior Cruciate Ligament Reconstruction, Part 2
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An Ecological Study of Anterior Cruciate Ligament Reconstruction, Part 2

机译：前交叉韧带重建的生态学研究，第2部分

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Background:Additional high-quality prospective studies are needed to better define the objective criteria used in relation to return-to-sport decisions after anterior cruciate ligament (ACL) reconstruction in active populations.Purpose:To investigate prospectively the relationship between functional performance test results at 24 weeks postoperative and return-to-sport activity (Tegner activity score) at 12 and 24 months, respectively, after synthetic (ligament advanced reinforcement system [LARS]) and autograft (doubled semitendinosus/gracilis [2ST/2GR]) ACL reconstructions.Study Design:Case series; Level of evidence, 4.Methods:A total of 64 patients who underwent ACL reconstruction (32 LARS, 32 2ST/2GR autograft; mean age, 27.9 years; body mass index [BMI], 24.9 kg/m2) were assessed preoperatively and at staged intervals postoperatively up to 24 weeks for isokinetic testing of quadriceps and hamstring average power per repetition at 60 deg/s and 180 deg/s, a battery of hop tests, peak vertical ground-reaction force (vGRF), and time to peak vGRF (in seconds) during a step- and jump-down task onto a force platform and peak speed (m/s) using a global positioning system (GPS unit) during a running task. A cohort of 32 healthy matched participants (mean age, 26.31 years; BMI, 25.7 kg/m2) were also tested to act as reference. Pearson correlation was calculated to assess correlation of each performance measure at 24 weeks postoperative with activity outcomes (Tegner score) at 12 and 24 months.Results:The strongest correlation between physical performance tests and return-to-sport outcomes was observed with peak speed during running. Large correlations were also observed for hamstring isokinetic power and hop test for distance. Moderate correlations were observed for timed hop, peak vGRF during a jump-down task, and quadriceps isokinetic power. No statistical correlations were observed for time to peak vGRF during a step-down and jump-down task as well as peak vGRF during a step-down task. When the performance tests were pooled together, mean postoperative improvements of 24% were observed from preoperative to 24 weeks within the surgical cohort. For each performance test, preoperative level of function strongly correlated with performance levels on the same test at 24 weeks.Discussion:The results of this study indicate that clinicians might seek to prioritize these tests and the rehabilitation themes they imply when seeking to maximize postoperative ACL activity outcomes. The observed strength between pre- and postoperative performance tests and return-to-sport outcomes within this study highlights the potential value of preoperative conditioning before undergoing ACL reconstruction. Future research should examine absolute predictive criterion thresholds for functional performance-based tests and reinjury risk reduction after ACL reconstruction.
机译：背景：需要进行更多高质量的前瞻性研究，以更好地定义活动人群前十字韧带（ACL）重建后与运动决策相关的客观标准目的：前瞻性研究功能性能测试结果之间的关系术后（复合韧带高级增强系统[LARS]）和自体移植（半腱肌/细纹肌[2ST / 2GR]加倍）分别在术后24周和运动后12周和运动恢复（Tegner活动评分）时研究设计：案例系列;证据等级，4。方法：术前和术后评估了64例行ACL重建的患者（32例LARS，32例2ST / 2GR自体移植;平均年龄27.9岁;体重指数[BMI] 24.9 kg / m2）。在术后长达24周的分阶段间隔内进行股四头肌和腿肌的平均运动测试，每次重复运动在60度/秒和180度/秒时进行，一系列跳跃测试，峰值垂直地面反应力（vGRF）和达到峰值的时间vGRF在执行任务期间使用全球定位系统（GPS单元）在降落和跳下任务到力平台上时（以秒为单位）和峰值速度（m / s）。还测试了32名健康匹配参与者（平均年龄26.31岁; BMI 25.7 kg / m2）作为参考。计算Pearson相关性，以评估术后24周每个绩效指标与12和24个月活动结局（Tegner评分）的相关性。结果：观察到体能测试与恢复运动结局之间的最强相关性是峰值速度运行。还观察到绳肌等速力和距离的跳跃测试之间存在较大的相关性。在定时跳，下跳任务中的峰值vGRF和股四头肌等速运动中观察到中等的相关性。在降落和跳下任务期间达到峰值vGRF的时间以及在降落任务期间达到峰值vGRF的时间均未观察到统计相关性。当将性能测试汇总在一起时，在手术队列中从术前到术后24周的平均术后改善率为24％。对于每个性能测试，术前功能水平与同一测试在24周时的性能水平密切相关。讨论：本研究结果表明，临床医生在寻求最大化术后ACL时可能会优先考虑这些测试及其暗示的康复主题。活动成果。在这项研究中，观察到的术前和术后性能测试与运动返回结果之间的强度突显了在进行ACL重建之前术前调节的潜在价值。未来的研究应检查基于功能性能的测试的绝对预测标准阈值，以及ACL重建后降低再损伤风险的阈值。

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