ACL重建联合前外侧关节外肌腱固定术在术后前9个月改善早期股四头肌力量和厚度，主要影响股中间肌。
简介
本研究纳入268例前交叉韧带重建（ACLR）患者（其中115例联合外侧关节外腱固定术，LET），比较术后3至9个月股四头肌厚度、肌力及IKDC评分的恢复轨迹。结果显示，LET组肌力增长显著（每3个月增加11.2N vs 非LET组5.9N），各肌束厚度恢复亦更优，但IKDC评分两组改善相当。提示ACLR联合LET可加速术后9个月内股四头肌形态与功能的恢复，值…
英文摘要
BACKGROUND: Quadriceps weakness and atrophy are most pronounced within the first three months following anterior cruciate ligament reconstruction (ACLr). Whether the addition of lateral extra-articular tenodesis (LET) accelerates recovery of quadriceps thickness, strength, and function remains unclear. Therefore, we aimed to describe the time course of recovery in quadriceps strength, muscle thickness, and International Knee Documentation Committee (IKDC) scores between 3 and 9 months following ACLr, with and without LET. METHODS: A total of 268 patients with ACLr (201 men; 115 with LET; mean age 30.4 ± 10.5 years, weight 77.8 ± 14.6 kg, height 1.72 ± 0.08 m) were included from 2019 to 2025. Quadriceps thickness, strength, and IKDC score were assessed at 3, 6, and 9 months postoperatively. Latent growth modeling (intercept and slope) was performed to evaluate adaptations over time between groups (with and without LET) from 3 to 9 months (α = 0.05). RESULTS: Outcomes improved over time (per 3-month interval) in both groups (with and without LET). IKDC scores increased by 13.4 and 13.9 points, respectively (both p < 0.001). Quadriceps strength increased by 11.2 N in the LET group (p < 0.001) and 5.9 N in the non-LET group (p = 0.155). Total quadriceps thickness increased by 0.71 and 0.63 cm, respectively (both p < 0.001). Similar increases were observed for rectus femoris (0.17 vs 0.14 cm), vastus intermedius (0.20 vs 0.13 cm), and vastus medialis thickness (0.17 vs 0.13 cm), all p < 0.001. CONCLUSION: Quadriceps thickness and strength between 3 and 9 months following ACLr show greater improvement when combined with LET, whereas IKDC scores show similar recovery regardless of LET use. These findings suggest that adding LET to ACLr results in a faster restoration of quadriceps thickness and strength within the first nine postoperative months.