MPFL重建青少年在下蹲和跳深着陆时下肢生物力学不对称
简介
本研究纳入20例MPFL重建术后青少年运动员与20名健康对照，通过三维运动捕捉和测力台评估其下蹲和落地跳（DVJ）时的下肢生物力学。主要发现：下蹲时，手术侧髋关节正/负功率增加，踝关节正/负功率增加，而膝关节正/负功率显著降低（分别降低41%和33.3%）；落地跳时，手术侧膝关节和踝关节正/负功率均低于非手术侧和健康对照组。下蹲时髋、膝关节功率对称性与落地跳…
英文摘要
PURPOSE: Evidence describing movement strategies during bilateral functional tasks after medial patellofemoral ligament (MPFL) reconstruction is limited, highlighting the need for biomechanical assessments to better inform rehabilitation progression and clinical decision-making. The purpose of the study was to investigate lower extremity biomechanics during squats and drop vertical jumps (DVJs) in adolescent athletes with MPFL reconstruction. METHODS: Twenty patients with MPFL reconstruction and 20 uninjured controls were included. Lower extremity biomechanics during squats and DVJs were assessed using a three-dimensional (3D) motion capture system and synchronized force plates. Primary variables included positive and negative joint power at the hip, knee and ankle, and secondary variables included peak joint flexion angles. Limbs and groups comparisons were examined using linear mixed-effects models. Exploratory analyses examined associations between symmetry indices for joint power during squats and DVJs in subjects with MPFL reconstruction using Pearson correlation coefficients. RESULTS: During squats, the surgical limb demonstrated greater hip positive and negative power and greater ankle positive and negative power, accompanied by lower knee positive (41% lower) and negative (33.3% lower) power (both p < 0.001) than the non-surgical limb. In between-group comparisons, the surgical limb exhibited lower knee and ankle positive and negative power compared with the uninjured controls. During DVJs, the surgical limb demonstrated lower knee positive and negative power and lower ankle positive and negative power compared with the non-surgical limb (p < 0.001 to 0.005) and uninjured controls (p < 0.001 to 0.044). Symmetry in hip and knee positive and negative power during squats was positively associated with symmetry during DVJs. CONCLUSION: Adolescent patients with MPFL reconstruction exhibited altered squat and jumping mechanics during the return to sport phase. Greater symmetry during squatting was associated with greater symmetry during jumping, suggesting evaluation of squat mechanics may provide clinically meaningful insights into movement strategy relevant to jumping and help guide rehabilitation progression. LEVEL OF EVIDENCE: Level III, case-control study.