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Strength and Function Across Maturational Levels in Young Athletes at the Time of Return to Sport After ACL Reconstruction

机译：ACL重建后返回运动时年轻运动员的实力和功能

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Background: The impact of maturation on lower extremity strength and function after anterior cruciate ligament reconstruction (ACLR) may help guide future studies of age-specific rehabilitation. Hypothesis: Pediatric ACLR patients would demonstrate higher thigh strength symmetry and knee-related function at return to sport (RTS) compared with adolescent and young adult participants who undeiwent traditional ACLR. Study Design: Prospective cohort study. Level of Evidence: Level 2. Methods: A total of 144 young athletes at the time of RTS clearance post-ACLR were classified into 3 maturational groups (pediatric, n = 16 with physeal-sparing ACLR [mean age = 12.3 years; range = 9.2-14.6 years]; adolescent, n = 113 [mean age = 16.5 years; range = 14.1-19.8 years]; young adult, n = 15 [mean age = 22.0 years; range = 20.5-24.9 years]). Quadriceps and hamstring strength were measured using an electromechanical dynamometer. Knee-related function was measured using the International Knee Documentation Committee (IKDC) subjective form and single-leg hop tests. The Limb Symmetry Index (LSI) was used in calculations for hop and strength tests. Group differences were compared with Kruskal-Wallis tests and Mann-Whitney U post hoc tests. Proportions of participants meeting literature-recommended RTS criterion cutoffs were compared among the groups using chi-square tests. Results: The pediatric group demonstrated higher quadriceps LSI (P = 0.01), IKDC scores (P < 0.01), single-hop LSI (P < 0.01), and crossover-hop LSI (P - 0.02) compared with the young adult group. In addition, the pediatric group demonstrated higher IKDC scores (P < 0.01) and single-hop LSI (P = 0.02) compared with the adolescent group. The adolescent group demonstrated higher IKDC scores (P < 0.01), single-hop LSI (P = 0.02), and crossover-hop LSI (P = 0.03) compared with the young adult group. The proportions of participants meeting all RTS criterion cutoffs were highest in the pediatric group and lowest in the young adult group (P = 0.03). Conclusion: Young athletes at RTS clearance after pediatric ACLR demonstrated higher quadriceps strength symmetry and knee-related function than adolescents and young adults after traditional ACLR. Clinical Relevance: These findings demonstrate the need for further study regarding the impact of these group differences on longitudinal outcomes after ACLR, including successful RTS and risk of second ACL injury.
机译：背景：成熟对前肢韧带重建后的下肢强度和功能的影响可能有助于指导未来对年龄特异性康复的研究。假设：儿科ACLR患者将展示较高的大腿强度对称和与膝关节相关的功能，以恢复运动（RTS）与未被传统ACLR的青少年和年轻成人参与者相比。研究设计：潜在队列研究。证据级别：方法：方法：RTS清除后的144名年轻运动员分为3个成立群体（儿科，N = 16，性能备件ACLR [均值年龄= 12.3岁;范围= 9.2-14.6岁];青少年，n = 113 [平均年龄= 16.5岁;范围= 14.1-19.8岁];年轻成人，n = 15 [平均年龄= 22.0岁;范围= 20.5-24.9岁]）。使用机电测功机测量QuadRiceps和腿筋强度。使用国际膝关节文件委员会（IKDC）主观形式和单腿跳测试测量膝关节相关功能。肢体对称指数（LSI）用于跳跃和强度测试的计算。将群体差异与Kruskal-Wallis测试和Mann-Whitney u Post Hoc测试进行了比较。使用Chi-Square试验比较了会议符合文献推荐的RTS标准截止的参与者的比例。结果：儿科小组展示较高的Quadriceps LSI（P = 0.01），IKDC分数（P <0.01），与年轻成年组相比，单跳LSI（P <0.01）和交叉跳LSI（P - 0.02）。此外，与青少年组相比，儿科小组表现出较高的IKDC评分（P <0.01）和单跳LSI（P = 0.02）。与年轻成年组相比，青少年组表现出较高的IKDC分数（P <0.01），单跳LSI（P = 0.02），和交叉跳LSI（P = 0.03）。与所有RTS标准截止解的参与者的比例在儿科群中最高，年轻成人组中最低（P = 0.03）。结论：小儿ACLR后RTS清关的年轻运动员在传统ACLR之后展示了比青少年和年轻成人更高的Quadriceps强度对称和膝关节的功能。临床相关性：这些研究结果表明需要进一步研究对ACLR后纵向结果对这些群体差异的影响，包括成功的RTS和第二次ACL损伤的风险。

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