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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Quadriceps Strength in Patients With Isolated Cartilage Defects of the Knee: Results of Isokinetic Strength Measurements and Their Correlation With Clinical and Functional Results
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Quadriceps Strength in Patients With Isolated Cartilage Defects of the Knee: Results of Isokinetic Strength Measurements and Their Correlation With Clinical and Functional Results

机译：膝关节软骨缺损患者的股四头肌力量：等速肌力测量结果及其与临床和功能结果的相关性

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Background: Recent studies have found a significant deficit of maximum quadriceps strength after autologous chondrocyte implantation (ACI) of the knee. However, it is unclear whether muscular strength deficits in patients with cartilage damage exist prior to operative treatment. Purpose: To isokinetically test maximum quadriceps muscle strength and quantify the impact of possible strength deficits on functional and clinical test results. Study Design: Cross-sectional study; Level of evidence, 3. Methods: To identify clinically relevant muscular strength deficits, 24 patients (5 females, 19 males; mean age, 34.5 years; body mass index, 25.9 kg/m~(2)) with isolated cartilage defects (mean onset, 5.05 years; SD, 7.8 years) in the knee joint underwent isokinetic strength measurements. Maximal quadriceps strength was recorded in 3 different testing modes: pure concentric contraction (flexors and extensors alternating work; con1), concentric-eccentric (only the extensors work concentrically and eccentrically; con2), and eccentric contraction in the alternating mode (ecc). Results were compared for functional performance (single-leg hop test), pain scales (visual analog scale [VAS], numeric rating scale [NRS]), self-reported questionnaires (International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Scale [KOOS]), and defect size (cm~(2)). Results: Compared with the uninjured leg, significantly lower quadriceps strength was detected in the injured leg in all isokinetic working modes (con1 difference, 27.76 N·m [SD 17.47; P = .003]; con2 difference, 21.45 N·m [SD, 18.45; P =.025]; ecc difference, 29.48 N·m [SD, 21.51; P = .001]), with the largest deficits found for eccentric muscle performance. Moderate negative correlations were observed for the subjective pain scales NRS and VAS. The results of the IKDC and KOOS questionnaires showed low, nonsignificant correlations with findings in the isokinetic measurement. Moreover, defect sizes (mean, 3.13 cm~(2)) were of no importance regarding the prediction of the strength deficit. The quadriceps strength deficit between the injured and the uninjured leg was best predicted by the results of the single-leg hop test. Conclusion: Patients with isolated cartilage defects of the knee joint have significant deficits in quadriceps muscle strength of the injured leg compared with the uninjured leg. The single-leg hop test may be used to predict quadriceps strength deficits. Future research should address whether preoperative strength training in patients with cartilage defects of the knee could be effective and should be taken into consideration in addition to surgical treatment.
机译：背景：最近的研究发现，自体膝关节软骨细胞植入（ACI）后，最大股四头肌力量明显不足。但是，尚不清楚在进行手术治疗之前是否存在软骨损伤患者的肌肉力量不足。目的：等速测试最大股四头肌肌肉，并量化可能的力量不足对功能和临床测试结果的影响。研究设计：横断面研究;证据等级，3。方法：为了鉴定临床相关的肌肉力量缺陷，有孤立的软骨缺损（平均）的24例患者（5例女性，19例男性;平均年龄：34.5岁;体重指数：25.9 kg / m〜（2））。在膝关节起病5.05年; SD 7.8年）进行了等速肌力测量。在三种不同的测试模式下记录了最大的股四头肌力量：纯同心收缩（屈肌和伸肌交替工作; con1），同心偏心（仅伸肌同心和偏心; con2）和偏心收缩以交替模式（ecc）。比较了功能表现（单腿跳试验），疼痛量表（视觉模拟量表[VAS]，数字评分量表[NRS]），自我报告的问卷（国际膝关节文献委员会[IKDC]，膝关节损伤和骨关节炎结果）的结果比例[KOOS]）和缺陷尺寸（cm〜（2））。结果：与未受伤的腿相比，在所有等速运动模式下，受伤腿部的股四头肌强度均显着降低（con1差异为27.76 N·m [SD 17.47; P = .003]; con2差异为21.45 N·m [SD] ，18.45; P = .025]; ecc差为29.48 N·m [SD，21.51; P = .001]），偏心肌的表现最大。在主观疼痛量表NRS和VAS上观察到中等程度的负相关。 IKDC和KOOS问卷的结果显示，与等速测量结果之间的相关性较低，无显着相关性。此外，缺陷尺寸（平均为3.13 cm〜（2））对于强度不足的预测并不重要。单腿跳试验的结果可以最好地预测受伤和未受伤的腿之间的股四头肌力量不足。结论：膝关节孤立性软骨缺损的患者与未受伤的腿相比，受伤腿的股四头肌肌肉力量明显不足。单腿跳测试可用于预测股四头肌力量不足。未来的研究应解决膝关节软骨缺损患者的术前力量训练是否有效，除手术治疗外还应考虑在内。

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