前交叉韧带重建术后股四头肌萎缩的异质性：一项纵向MRI研究
简介
该纵向MRI研究纳入13例ACLR患者，分别在术后6个月和1年测量股四头肌各头（股内侧肌、股外侧肌、股中间肌、股直肌）体积及等速肌力。结果发现，所有肌头均持续萎缩，以股内侧肌和股外侧肌为著，且术后1年内各肌头体积无明显恢复，肌肉体积与力量恢复之间无显著相关性。提示ACLR后康复需同时关注肌肉形态与功能恢复，而非仅侧重肌力训练。
英文摘要
OBJECTIVES: This study used MRI to longitudinally assess the differences in atrophy among individual quadriceps muscles and the association between muscle volume and strength recovery following ACL reconstruction (ACLR). DESIGN: Longitudinal within-subject. SETTING: Laboratory. PARTICIPANTS: 13 subjects with unilateral ACLR. MAIN OUTCOME MEASURES: MRI and isokinetic strength of bilateral quadriceps muscles were acquired at 6 months and 1 year post-ACLR. The volumes of the 4 quadriceps muscles (vastus medialis, VM; vastus lateralis, VL, vastus intermedius, VI; rectus femoris, RF) were measured. The degree of atrophy for each muscle was calculated as % difference of the uninjured leg. RESULTS: At both time points, all 4 quadriceps muscles of the ACLR legs were significantly smaller than the uninjured legs (P < 0.001), with greater atrophy in VM/VL than VI/RF (P ≤ 0.045). None of the 4 quadriceps muscles of the ACLR legs showed significant volumetric changes over time (P > 0.171). Quadriceps volume and strength recovery in the ACLR legs were not significantly correlated (r = 0.50, P = 0.09). CONCLUSIONS: Persistent quadriceps atrophy was found 1 year post-ACLR with greater atrophy in VL/VM than VI/RF. Limited and heterogeneous muscle hypertrophy over time and the lack of strong association between hypertrophy and strength recovery highlight the need for rehabilitation promoting both morphological and functional recovery.