采用力传感鞋垫比较前交叉韧带重建术后步行步态变化的移植物来源
简介
一项前瞻性队列研究纳入27例单侧前交叉韧带重建（ACLR）患者（13例骨-髌腱-骨、14例股四头肌腱自体移植物），使用力感应鞋垫评估术后6至12个月步行时患侧肢体负荷对称性的变化。关键发现：随时间推移，ACLR侧肢体的峰值冲击力、平均加载率和瞬时加载率均显著增加，但对侧肢体及肢体对称指数无显著变化；两种移植物来源组间在肢体对称指数变化上无差异。IKDC评分显…
英文摘要
CONTEXT: Up to 36% of patients will develop osteoarthritis within a decade of anterior cruciate ligament reconstruction (ACLR), and postoperative changes in gait mechanics have been shown to be associated with radiographic and biochemical markers of cartilage degeneration. OBJECTIVES: To characterize changes in limb-loading symmetry during walking gait from 6 to 12 months after ACLR in patients with extensor mechanism autografts using force-sensing insoles and to compare the change in limb-loading metrics between patients with bone-patellar tendon-bone (BPTB) and quadriceps tendon (QT) autografts. DESIGN: Prospective cohort study. SETTING: Orthopaedic rehabilitation clinics. PATIENTS OR OTHER PARTICIPANTS: Twenty-seven participants (20 female; 13 BPTB, 14 QT; age = 21.4 ± 6.1 years) who underwent unilateral, primary ACLR with a BPTB or QT autograft. MAIN OUTCOME MEASURES: Gait assessment, the International Knee Documentation Committee (IKDC) survey, and the ACL-Return to Sport after Injury (ACL-RSI) survey were completed 6 ± 1 and 12 ± 2 months post-ACLR. RESULTS: Participants experienced a significant increase in ACLR limb peak impact force (P = .007), average loading rate (P = .043), and instantaneous loading rate (P = .021) over time, but no significant changes were found in the contralateral limb or limb symmetry index (LSI). No differences were found in the change in LSI for any variable between graft cohorts. Participants experienced a significant improvement in the IKDC score, but the ACL-RSI score did not significantly improve. CONCLUSIONS: When tested in the clinical environment using force-sensing insoles, an increase in ACLR limb loading occurred from 6 to 12 months post-ACLR, but this change is not affected by autograft source.