竞技足球运动员前交叉韧带重建术中部分厚度与全厚度股四头肌腱移植物相比更早恢复肌力
简介
该回顾性队列研究纳入42例非职业竞技足球运动员，对比ACL重建术中全厚与半厚股四头肌腱自体移植物的临床疗效。结果显示半厚度组术后6个月内股四头肌肌力对称性恢复更快（60°/s、180°/s及300°/s角速度下均有显著差异），但12个月时两组趋于一致，再损伤率亦无差异。提示半厚度移植物有利于竞技人群早期力量恢复，可作为移植物选择的参考依据。
英文摘要
PURPOSE: This study aimed to compare strength recovery, functional and clinical outcomes between full- and partial-thickness quadriceps tendon autografts for 12 months post-operatively and to examine the clinical implications of graft thickness in anterior cruciate ligament reconstruction among non-professional competitive soccer players. METHODS: 42 non-professional competitive Spanish federal soccer players who underwent primary anterior cruciate ligament reconstruction using either full- or partial-thickness quadriceps tendon grafts were included in this retrospective cohort study. Both groups followed standardised surgical and rehabilitation protocols. Evaluations were assessed preoperatively and at 3, 6 and 12 months post-operatively, with the reinjury rates recorded at 24 months. Quadriceps index, measured by isokinetic dynamometry was the primary outcome. Hamstring index, extension and flexion peak torque, single leg hop test, patient-reported outcome measures (Lysholm and Cincinnati Knee Rating System scores) and reinjury rate were evaluated as secondary outcomes. Statistical analysis was performed using repeated-measures ANCOVA with a Bonferroni adjustment, and the significance level was set at 5%. RESULTS: During the first 6 months, faster recovery of quadriceps symmetry was observed in partial-thickness group compared to the full-thickness group at 300°/s (mean difference: -26.5, 95% confidence interval [CI] [-51.4, -1.7], p = 0.037), 180°/s (mean difference: -31.0, 95% CI [-56.0, -6.0], p = 0.017), and 60°/s (mean difference: -31.2, 95% CI [-55.4, -7.0], p = 0.013), as well as greater improvement in extension peak torque. No statistical differences (p > 0.05) remained between groups at 12 months, with both groups achieving similar recovery. Hop test and clinical outcomes improved significantly over time in both groups, without significant between-group differences (p > 0.05). Reinjury rate was similar between groups (p = 0.634). CONCLUSIONS: Earlier strength recovery was observed with partial-thickness graft after ACL reconstruction, highlighting the clinical relevance of graft choice in early rehabilitation in competitive soccer players. LEVEL OF EVIDENCE: Level II.