联合ACL与ALL重建较单纯ACL重建在术后早期可获得更好的姿势控制
简介
67例患者（单纯ACL重建37例、ACL+ALL重建30例）在术前及术后3、6个月行Biodex和Y平衡测试（YBT），评估静态与动态姿势控制。联合重建组术后3个月动态姿势控制优于单纯ACL重建，YBT后内侧、后外侧方向（反映旋转稳定性）改善更显著。对合并前外侧不稳者，ACL+ALL重建可作为改善早期姿势控制的术式选择，但样本量有限。
英文摘要
BACKGROUND: Recent studies suggest that the anterolateral ligament (ALL) contributes to knee rotational stability by acting synergistically with the anterior cruciate ligament (ACL). Although combined ACL and ALL reconstruction has shown benefits in physical examination, subjective physical scales, and return-to-sport or re-rupture rates, few studies have compared postural control. This study aimed to compare postural control between isolated ACL reconstruction and combined ACL and ALL reconstruction. METHODS: Between June 2016 and July 2022, patients who underwent isolated ACL reconstruction (n = 37) or combined ACL and ALL reconstruction (n = 30) were included. Static and dynamic postural control were assessed using the Biodex Balance System and the Y-balance test (YBT) preoperatively and at three and six months postoperatively. FINDINGS: A total of 67 patients were enrolled, including 49 men and 18 women, with a mean age of 30.2 ± 8.1 years and a mean body mass index of 25.98 ± 3.6 kg/m2. In the YBT, which assesses dynamic postural control as the contralateral limb moves away from the center of gravity, significant main effects of time and group were observed, except in the anterior direction. The YBT-posteromedial (p = 0.009) and YBT-posterolateral (p = 0.049) directions, which reflect knee rotational stability, was significantly better in the combined ACL and ALL reconstruction group than in the isolated ACL reconstruction group. INTERPRETATION: At three months postoperatively, combined ACL and ALL reconstruction showed better dynamic postural control than isolated ACL reconstruction, particularly during tasks requiring multidirectional postural adjustments.