Isokinetic Quadriceps and Hamstring Muscle Strength After Anterior Cruciate Ligament Reconstruction: Comparison Between Single-bundle and Double-bundle Reconstruction: 前十字韌帶重建手術後股四頭肌和腿後肌羣(膕繩肌)的等速肌力︰單束和雙束前十字韌帶重建術之比較

IntroductionClinical studies have not yet proven whether single-bundle (SB) or double-bundle (DB) anterior cruciate ligament (ACL) reconstruction is superior. Nonetheless, quadriceps and hamstring muscle deficit is common after ACL reconstruction and it may affect the final outcome. The purpose of this study was to compare the isokinetic quadriceps and hamstring muscle strength after SB-ACL and DB-ACL reconstruction.Materials and methodsWe recruited 40 patients with ACL reconstruction (20 SB and 20 DB) by the same team of surgeons from 2006 to 2009. Demographic data of both groups were comparable. Lower extremity concentric isokinetic peak extension and flexion torques were assessed at angular velocities of 60°/second, 180°/second, and 300°/second preoperatively and at least 1 year postoperatively. Clinical evaluation was performed, including anterior stability with an arthrometer (model KT-1000), Lysholm score, Tegner activity score, single leg hop test, and International Knee Documentation Committee score. Data were analysed statistically.ResultsThe isokinetic quadriceps and hamstring peak torque values in both the SB and DB groups did not show any significant difference. The maximum displacement upon KT-1000 arthrometer measurement appeared lower in the DB group but the difference was not significant. The side-to-side percentage deficits in quadriceps and hamstring peak torque at postoperative assessment were comparable in both groups.ConclusionIsokinetic quadriceps and hamstring muscle strength after SB-ACL or DB-ACL reconstruction was comparable.

中文摘要簡介：現有的臨床研究尚未能證明單束或雙束前十字韌帶重建手術的相對優越性。儘管如此，股四頭肌和腿後肌羣(膕繩肌)力量不足是前十字韌帶重建手術後的普遍現象，它可能會影響術後的成果。本研究之目的是比較單束和雙束前十字韌帶重建後股四頭肌和腿後肌羣(膕繩肌)的等速肌力。方法：於2006至2009年間，有40名前十字韌帶重建手術病人(分別為20名單束重建和20名雙束重建患者) 被納入這個研究，手術都是由同一組骨科醫生所做的。這兩個組別的人口統計數據並無分別。於術前和手術後至少1年，我們量度下肢分別於角速度每秒60度，180度和300度的同心等速伸長和屈曲最大扭力值。另進行了多項臨床評估，包括關節動度計測試 (型號KT-1000)，Lysholm評分，Tegner活動評分，單腿跳測試，國際膝關節文獻委員會(IKDC)評分，並對數據進行統計分析。結果：比較單束重建和雙束重建組別，發現股四頭肌和腿後肌羣(膕繩肌)的等速最大扭力值沒有顯著的差別。 KT-1000關節動度計顯示雙束重建組別有較少的脛骨前移差值，但這差異於統計學上並無分別。於手術後的評估中，比較股四頭肌和腿後肌羣(膕繩肌)的最大扭力值較對側腿之差別百分比，並無分別。結論：單束和雙束前十字韌帶重建後的股四頭肌和腿後肌羣(膕繩肌)等速肌力比較，兩者相約。