|Relationship Between Quadriceps Strength and Patellofemoral Joint Chondral Lesions After Anterior Cruciate Ligament Reconstruction|
|Wang, Hai-Jun; Ao, Ying-Fang; Jiang, Dong; Gong, Xi; Wang, Yong-Jian; Wang, Jian; Yu, Jia-Kuo|
|关键词||anterior cruciate ligament reconstruction patellofemoral joint cartilage second-look arthroscopy quadriceps strength|
|刊名||AMERICAN JOURNAL OF SPORTS MEDICINE|
|WOS标题词||Science & Technology|
|类目[WOS]||Orthopedics ; Sport Sciences|
|研究领域[WOS]||Orthopedics ; Sport Sciences|
|关键词[WOS]||2ND-LOOK ARTHROSCOPIC EVALUATION ; PATELLAR TENDON-BONE ; HAMSTRING TENDON ; MUSCLE STRENGTH ; FOLLOW-UP ; SEMITENDINOSUS TENDON ; ISOKINETIC QUADRICEPS ; KNEE OSTEOARTHRITIS ; ARTICULAR-CARTILAGE ; ACL RECONSTRUCTION|
Background: The incidence of the patellofemoral joint chondral lesions after anterior cruciate ligament reconstruction (ACLR) is disturbingly high. Few studies have assessed the factors affecting patellofemoral joint chondral lesions postoperatively.
Hypothesis: The recovery of quadriceps strength after ACLR could be associated with patellofemoral joint cartilage damage.
Study Design: Cohort study; Level of evidence, 3.
Methods: A total of 88 patients who underwent arthroscopic anatomic double-bundle ACLR with hamstring autografts received second-look arthroscopy at the time of metal staple removal at an average of 24.1 months (range, 12-51 months) postoperatively. All patients underwent standardized isokinetic strength testing for bilateral quadriceps and hamstrings 1 to 2 days before second-look arthroscopy. The patients were divided into 2 groups: Patients in group 1 had a 20% deficit on the peak torque measures for quadriceps compared with that of the contralateral knee, whereas those in group 2 had a <20% deficit on peak torque. Cartilage status at the patellofemoral joint and tibiofemoral joint were evaluated by second-look arthroscopy and the Outerbridge classification. Other assessments included the International Knee Documentation Committee (IKDC) score, Tegner and Lysholm scores, side-to-side difference on KT-2000 arthrometer, and range of motion.
Results: There were 42 patients included in group 1 and 46 patients in group 2. The mean postoperative quadriceps peak torque of the involved knee compared with the contralateral knee was 70% (range, 57%-80%) in group 1 and 95% (range, 81%-116%) in group 2. For all patients, a significant worsening was seen in the patellar and trochlear cartilage (P = .030 and <.001, respectively) but not at the medial or lateral tibiofemoral joint after ACLR. A significant worsening in the status of both patellar and trochlear cartilage was seen after ACLR in group 1 (P = .013 and =.011, respectively) and of trochlear cartilage in group 2 (P = .006). Significantly fewer severe chondral lesions of the patella were found in group 2 than in group 1 (proportion of patients whose cartilage grade worsened: 26% vs 48%, P < .05; difference in cartilage grade: 0.09 vs 0.62, P < .05). There was no significant difference for trochlear chondral worsening between the 2 groups. No significant differences were detected between the 2 groups in terms of hamstring strength; Lysholm, Tegner, and IKDC scores; KT-2000 arthrometer anterior laxity; or range of motion.
Conclusion: Greater than 80% recovery of quadriceps strength after ACLR is associated with less severe patellar cartilage damage at short-term follow-up.
|项目编号||31200725 ; 51273004|
|资助机构||National Natural Scientific Foundation of China|
|作者单位||Peking Univ, Inst Sports Med, Hosp 3, Beijing 100191, Peoples R China|
|Wang, Hai-Jun,Ao, Ying-Fang,Jiang, Dong,et al. Relationship Between Quadriceps Strength and Patellofemoral Joint Chondral Lesions After Anterior Cruciate Ligament Reconstruction[J]. AMERICAN JOURNAL OF SPORTS MEDICINE,2015,43(9):2286-2292.|
|APA||Wang, Hai-Jun.,Ao, Ying-Fang.,Jiang, Dong.,Gong, Xi.,Wang, Yong-Jian.,...&Yu, Jia-Kuo.(2015).Relationship Between Quadriceps Strength and Patellofemoral Joint Chondral Lesions After Anterior Cruciate Ligament Reconstruction.AMERICAN JOURNAL OF SPORTS MEDICINE,43(9),2286-2292.|
|MLA||Wang, Hai-Jun,et al."Relationship Between Quadriceps Strength and Patellofemoral Joint Chondral Lesions After Anterior Cruciate Ligament Reconstruction".AMERICAN JOURNAL OF SPORTS MEDICINE 43.9(2015):2286-2292.|