客观功能与平衡测试在儿童前交叉韧带重建术后安全重返运动中的重要性：一项两年前瞻性研究
简介
本研究前瞻性评估了44例骨骺未闭患者（中位年龄14岁，范围9-16岁）行经骺板腘绳肌腱自体移植物ACL重建术后2年的功能恢复情况。术前及术后6、12、24个月采用功能性动作筛查（FMS）、单腿下蹲（SLS）、Y-Balance测试（YBT-LQ）及主观膝关节评分（SKV）进行评估。关键发现：FMS评分从术后6个月起持续改善至24个月（p=0.024）；SKV…
英文摘要
INTRODUCTION/OBJECTIVES: Pediatric anterior cruciate ligament reconstruction (ACLR) outcomes, particularly long-term functional recovery and return-to-sport (RTS), remain debated and have not been well characterized in skeletally immature patients. This study evaluated functional movement competency, balance, and subjective knee function over a two-year follow-up in skeletally immature patients undergoing ACLR. METHODS: Forty-four skeletally immature patients (15 girls, 29 boys median age 14, range 9-16) undergoing transphyseal ACLR using semitendinosus tendon autograft in a single center were prospectively assessed. Functional Movement Screen (FMS), Simple Knee Value (SKV), Single Leg Squat (SLS), and Y-Balance Test-Lower Quarter (YBT-LQ) were administered preoperatively and at 6, 12, and 24 months postoperatively. Linear mixed models (ANOVA or non-parametric tests) and post-hoc comparisons were used for statistical analysis. RESULTS: FMS scores improved throughout the two-year follow-up (p=0.024), with increases observed from 6 months postoperatively. SKV also demonstrated continuous improvement at all time points (p<0.001). However, no clinically meaningful correlation was found between SKV and FMS scores over time. SLS showed differences at 24 months for both the operated (0.6; p=0.004) and contralateral leg (0.6; p=0.03), though with minimal clinical relevance. YBT-LQ composite scores statistically improved bilaterally at 24 months, with minimal clinical relevance in the contralateral leg (-3.7; p=0.011). The inter-limb difference in composite scores remained stable over time. YBT-LQ anterior reach distance progressively improved in the operated leg from 6 to 24 months. The inter-limb difference in anterior reach distance did not change over time. CONCLUSION: Pediatric ACLR patients demonstrated progressive functional improvement over two years, with additional improvements occurring beyond 12 months, supporting the potential value of extended rehabilitation and reassessment. The lack of correlation between subjective and objective measures underscores the need for comprehensive assessments, including functional tests, for safe RTS decisions, as subjective knee perception poorly reflects actual movement capacity Level of Evidence: II.