ACL重建术后不同移植物类型的等速肌力恢复比较
简介
该研究比较了股四头肌腱（QT）、腘绳肌腱（HT）、骨-髌腱-骨（BPTB）及同种异体移植物在ACL重建术后等速肌力恢复的差异。共纳入262例患者，术后3、6、9、12个月检测肌力。结果显示：移植物类型显著影响股四头肌伸膝力量恢复（校正后p<0.05），HT自体移植物和异体移植物恢复优于QT和BPTB；而HT移植物腘绳肌屈膝力量恢复最差，提示供区缺损。临床意义…
英文摘要
BACKGROUND: Although clinical and functional outcomes have been investigated following ACL reconstruction across graft types, few studies have examined serial measures of quadriceps and hamstring strength. This study compared isokinetic quadriceps and hamstrings muscle strength recovery among quadriceps tendon graft (QT), hamstring tendon graft (HT), bone-patellar tendon-bone graft (BPTB), and allograft ACLR procedures. METHODS: A retrospective review of patients aged 16-35 who underwent primary ACLR at a single sports medicine department was conducted. A total of 262 participants were included (HT = 134, QT = 67, BPTB = 27, allograft = 34). Isokinetic strength data were analyzed at 3, 6, 9, and 12 months postoperatively. Linear mixed models evaluated associations between graft type, time, and strength outcomes. Because groups differed with regards to age, sex, and concomitant meniscus procedures, these factors were included as covariates in each model. RESULTS: Graft type was associated with quadriceps extension strength (p < 0.05 adjusted), while time by graft interaction was not. HT autografts and allografts demonstrated higher LSI extension values than QT and BPTB grafts. For hamstring flexion strength, HT grafts exhibited lower LSI values than other QT and BPTB grafts, suggesting donor-site deficits. CONCLUSION: Quadriceps strength recovery differs by graft type following ACLR, with QT and BPTB grafts showing delayed recovery compared to HT and allografts whereas hamstring strength recovery appears to be more impaired following the use of HT grafts. These findings may inform graft-specific rehabilitation strategies for ACLR.