前交叉韧带重建术后膝关节多平面肌肉支撑紊乱
简介
该研究通过肌电驱动的神经肌肉骨骼建模，比较了11例行腘绳肌肌腱自体移植物ACL重建患者与11名健康对照者在侧切动作中下肢肌肉对膝关节多平面负荷的贡献。结果显示，ACLR患者腘绳肌对膝关节后向力的贡献显著减小，而股四头肌对外翻和外旋力矩的贡献增大，提示术后肌肉支撑模式存在持续性多平面改变，可能与移植物负荷及二次ACL损伤风险相关。
英文摘要
This study compared lower-limb muscle contributions to multi-planar knee loading between individuals with anterior cruciate ligament reconstruction (ACLR) and healthy controls during sidestep cutting. Eleven ACLR participants with quadrupled hamstring autografts and eleven matched healthy controls performed pre-planned sidestep cutting. Whole-body kinematics, ground reaction forces, and electromyograms (EMG) were recorded. An EMG-informed neuromusculoskeletal modelling approach was used to estimate muscle contributions to anteroposterior force (in bodyweights, BW), varus/valgus moment (BW*Height, BWH), and internal/external rotation moment (BWH) at the knee. Between-group differences in muscle contributions to knee loads were assessed comparing their means +/- standard deviation and their effect sizes (Cohen's d). Compared to controls, ACLR participants had smaller hamstring contributions to posterior knee force (-0.165 ± 0.08 vs -0.343 ± 0.05 BW; d = 2.66), greater quadriceps contributions to valgus moments (-0.080 ± 0.04 vs - 0.050 ± 0.02 BWH; d = 0.94), and greater quadriceps contribution to external rotation moments (-0.042 ± 0.01 vs - 0.025 ± 0.01 BWH; d = 1.7). In conclusion, participants with ACLR exhibited persistent multi-planar alterations in muscle contribution patterns during sidestep cutting, characterised by reduced hamstring contributions, which may be relevant to ACL graft loading and secondary ACL injury risk but require further investigation.