腓骨长肌腱移植重建前交叉韧带后外翻肌力下降：等速肌力测试研究
简介
该研究评估了取腓骨长肌腱（PLT）用于前交叉韧带（ACL）重建后供侧踝关节的功能变化。共纳入31例患者，平均年龄32.61岁，平均随访18.34个月，通过等速肌力测试（IMST）测量双踝外翻肌和内翻肌肌力，并采用足踝能力评分（FAAM）和足踝结局评分（FAOS）评估主观功能。关键发现：PLT移植物平均长度29.32 cm、直径9.32 mm；术后6个月时，6…
英文摘要
AIMS: There are conflicting results in the literature regarding the safety of the peroneus longus tendon (PLT) as a potential graft for anterior cruciate ligament (ACL) reconstruction, and no long-term studies with objective assessment exist. Therefore, we assessed the donor ankle following PLT harvest for ACL reconstruction using isokinetic muscle strength testing (IMST) of the evertors and invertors of both feet. METHODS: The study included 31 patients with a mean age of 32.61 years (SD 10.60) and a mean follow-up period of 18.34 months (SD 6.25). IMST of evertors and invertors of both feet was conducted. Subjective outcomes were assessed using the Foot and Ankle Ability Measure (FAAM) score and the Foot and Ankle Outcome Score (FAOS). To compare the different parameters between timepoints, repeated measures of analysis of variance/Friedman test were used. RESULTS: The mean length and diameter of the PLT graft were 29.32 cm (SD 2.26) and 9.32 mm (SD 0.92), respectively. A statistically significant decrease in peak torque at 60°/second was observed at six months for both evertors (p < 0.001) and invertors (p = 0.010). No statistically significant difference in peak torque was observed at one year at 60°/second (evertors: p = 0.386; invertors: p = 0.685) or 120°/second (evertors: p = 0.071; invertors: p = 0.156). The difference in FAAM (p = 0.621) and FAOS (p = 0.456) scores was not statistically significant. CONCLUSION: PLT harvest for ACL reconstruction can initially cause weakness in evertors and invertors. However, ankle-specific rehabilitation may restore strength over time. While overall ankle function remains intact, stronger evidence is needed to support PLT as a primary graft. It may be suitable for select cases, such as multiligament injuries or revisions, with appropriate ankle rehabilitation.