青少年使用自体腘绳肌腱移植物行ACL重建与4个月时坐位等速测试180°/s下屈膝肌力缺陷无关联
简介
该回顾性病例对照研究纳入93例≤18岁首次ACL重建者，均用自体腘绳肌腱；术前及术后4个月以180°/s坐位等速测试膝屈伸峰值扭矩并计算LSI。术侧屈、伸肌力较术前无显著下降，对侧健康侧力量显著增加，LSI显著降低且伸肌降幅大于屈肌（12% vs 7%）。提示该移植物未致4个月屈伸力量缺陷，但术后不对称主要来自对侧增强，康复仍需重视股四头肌强化。
英文摘要
PURPOSE: This study aimed to analyse the effect of using an ipsilateral hamstring (HS) autograft on early postoperative knee strength following anterior cruciate ligament reconstruction (ACLR) in adolescents. METHODS: This retrospective, single-centre study included patients aged ≤18 years who underwent primary ACLR with HS tendon autografts between January 2022 and January 2025. Demographic and operative data were collected. Isokinetic knee flexion and extension peak torque was assessed bilaterally at 180°/s using a standardized dynamometer protocol, and Limb Symmetry Index (LSI) was calculated preoperatively and at 4 months postoperatively. RESULTS: Ninety-three patients met the inclusion criteria (mean age, 15.6 ± 1.3 years). No significant postoperative strength deficits were detected in the operated limb for either flexion (p = 0.672) or extension (p = 0.316) compared with preoperative values. The contralateral healthy limb demonstrated significant strength gains in both flexion and extension (p < 0.001). The LSI decreased significantly postoperatively (p < 0.001), with a greater reduction in extension compared with flexion (12% vs. 7%). There were no differences in LSI between female and male patients. CONCLUSIONS: ACLR in adolescents using an ipsilateral HS autograft was not found to be associated with significant postoperative flexion or extension strength deficits on the operated limb at 4 months. The postoperative asymmetry seemed primarily driven by strength gains in the contralateral healthy limb. These findings highlight the importance of not overlooking quadriceps strengthening even when using an HS autograft and support the continued use of this graft choice in adolescents, especially regarding the preservation of flexion strength. LEVEL OF EVIDENCE: Level III, retrospective case-control study.