前交叉韧带损伤并发或不并发髌股关节软骨损伤等速角度力矩曲线的差异

目的 探讨前交叉韧带损伤并发或不并发髌股关节软骨损伤患者的等速角度力矩曲线差异。方法 回顾分析2018年9月至2019年9月行膝关节镜探查术并在术前行等速肌力测试的患者,选取年龄、性别、半月板损伤相匹配的前交叉韧带损伤并发或不并发髌股关节软骨损伤患者各17例。术前采用等速肌力测试仪进行180°/s、60°/s的膝关节等速和等长屈伸测试。采用1°递增的平均力矩结果进行标准化(力矩/体质量),比较两组间角度力矩曲线差异。结果 180°/s下,两组间健侧和患侧屈膝力矩比较均无显著性差异(P > 0.05);两组间健侧伸膝力矩比较无显著性差异( P > 0.05),患侧伸膝力矩在88°~90°有显著性差异( t > 2.102, P < 0.05),余角度均无显著性差异( P > 0.05)。60°/s下,两组间健侧屈膝力矩在62°~82°有显著性差异(| t| >2.056, P < 0.05),余角度无显著性差异;两组间患侧屈膝力矩比较无显著性差异( P > 0.05);两组间健侧和患侧伸膝力矩比较均无显著性差异( P > 0.05),但无软骨损伤的伸膝力矩有高于髌股软骨损伤的趋势。在180°/s等速屈伸力矩曲线的起始阶段会出现一个曲线变化。髌股软骨损伤组患侧等长伸膝力矩明显小于无髌股软骨损伤组( t = 2.858, P < 0.01),两组间患侧等长屈膝及健侧屈、伸力矩比较无显著性差异( t < 1.905, P > 0.05)。 结论 前交叉韧带损伤并发髌股软骨损伤较不并发髌股软骨损伤患者的等速运动速度越低,力量差异越显著。并发髌股软骨损伤的前交叉韧带损伤患者训练力量时建议采用高速运动。

Difference of Isokinetic Angle-Specific Moment Curves in Anterior Cruciate Ligament-injured Patients with or without Patellofemoral Articular Cartilage Injury

Objective To investigate the difference of isokinetic angle-specific moment curves between anterior cruciate ligament (ACL)-injured patients with and without patellofemoral cartilage injury (PFCI).Methods A retrospective analysis was performed on patients underwent knee arthroscopy and isokinetic muscle strength testing before surgery from September, 2018 to September, 2019. Seventeen ACL-injured patients with PFCI and 17 ACL-injured patients without PFCI who matched in age, sex and meniscus injury were selected. Before arthroscopy, isometric and isokinetic strength of knee flexion and extension at velocity of 180°/s and 60°/s was tested by isokinetic dynamometer. Normalized torque-angle curves (torque/body mass) were generated in steps of 1° and the differences in angle-specific moment curves between two groups were compared.Results At 180°/s, there was no significant difference in flexion isokinetic torque both healthy side and affected side between two groups (P >0.05); and no difference in extension torque of the healthy side ( P >0.05), however, there was significant difference in extension torque of the affected side at 88° to 90° between two groups ( t > 2.102, P <0.05). At 60°/s, there was significant difference in flexion torque of the healthy side at 62° to 82° between two groups (| t| >2.056, P <0.05), and no significant difference was found in flexion torque of the affected side ( P >0.05), nor in extension torque of both sides between two groups ( P > 0.05). A curve change was found at the beginning of the flexion and extension isokinetic moment curves at the velocity of 180°/s. The isometric knee extension torque was significantly different in the affected side between two groups ( t = 2.858, P < 0.01), and no difference was found in isometric knee flexion torque in the affected side as well as both extension and flexion torques in the healthy side between two groups ( t < 1.905, P > 0.05). Conclusion The lower the isokinetic speed, the more significant the difference of strength is between ACL-injury patients with and without PFCI. High speed exercise is recommended for ACL-injured patients with PFCI.