髌韧带替代前交叉韧带重建术后股四头肌及绳肌等速测试结果  

The results of isokinetic testing of quadriceps and hamstrings following bone-patellar tendon-bone anterior cruciate ligament reconstruction

作　　者：蒋斌[1] 杨佩君[1] 卞昂 于哲一 何国础[1] 

机构地区：[1]上海第二医科大学附属瑞金医院康复科,上海瑞金二路197号200025

出　　处：《中国康复医学杂志》2001年第6期355-358,共4页Chinese Journal of Rehabilitation Medicine

摘　　要：目的 :评价前交叉韧带 (ACL)损伤经骨 -髌韧带 -骨 (BPB)重建术后患侧及健侧膝关节股四头肌及绳肌的向心性收缩及离心性收缩功能的变化 ,重点观测作为协同保护前交叉韧带的绳肌拮抗性离心性收缩在不同运动速度及不同的关节位置下的功能变化。方法 :用Cybex - 770型等速测试系统对 30例陈旧性前交叉韧带损伤经关节镜行BPB替代ACL重建术后的患者进行患肢及健肢的股四头肌及绳肌的向心性和离心性收缩的肌肉功能进行测试。结果 :显示在 30°/s、6 0°/s、90°/s、12 0°/s的 4组测试运动速度下患膝的股四头肌及在 30°/s、6 0°/s、90°/s三组测试运动速度下患膝绳肌的向心性及离心性收缩的峰力矩都较健侧有明显下降 ,具显著性差异 (P <0 .0 5 ) ,而在 12 0°/s运动速度下两下肢绳肌的向心性及离心性收缩峰力矩已无显著性差异。患肢绳肌离心性收缩与股四头肌向心性收缩的峰力矩之比 (H/Q的E/C)及两者的向心性收缩峰力矩之比 (H/Q的C/C)在 4组运动速度下均大于健侧 ,具极显著性差异 (P <0 .0 1)。随着运动速度的加大及膝关节的伸直两个比值逐步加大 ,H/Q的E/C比值在膝关节近伸直位时达到最高峰。结论 :前交叉韧带损伤BPB替代ACL重建术后患肢的股四头肌及绳肌都发生了废用性萎缩 ,但后者比前者?Objective: To evaluate the functional change of concentric and eccentric contraction of quadriceps and hamstrings. Specially attention was paid in the changing of antagonist coactivation of hamstrings in protecting the anterior cruciate ligament under various movement speeds and joint positions. Method: Applying Cybex-770 isokinetic test system on assessing concentric and eccentric contraction of quadriceps and hamstrings involving bilateral limbs in 30 cases suffered from anterior cruciate ligament injured and underwent arthroscopically assisted bone-patellar tendon-bone ACL reconstruction. Result: Compared with the uninjured limb, there were significant differences in concentric and eccentric contraction peak torque of quadriceps of injured limb at four isokinetic speeds 30°/s , 60°/s, 90°/s, 120°/s and these of hamstrings of injured limb at three isokinetic speeds 30°/s ,60°/s ,90°/s(P<0.05). But no significant difference was found in concentric and eccentric contraction peak torque of hamstrings at 120°/s speed between injured group and uninjured group. The magnitudes of the hamstrings/quadriceps E/C and C/C ration increase significantly with speed in both groups of subject (P<0.01), hamstrings/quadriceps E/C rations tended to rise with muscle length as the keen joint was extended, Peak rations were generated at the most extended joint positions. Conclusion: Quadriceps and hamstrings muscles suffered from waste atrophy following the anterior cruciate ligament reconstruction. But hamstrings recovery faster than quadriceps. In postoperative two years there are no significant differences in muscle contraction function of hamstrings between injured group and uninjured group under fast movement speed. The subject appeared to accomandately enforce the function of knee flexors, specially in eccentric contraction,in order to protect the ACL graft. Along with the speed increasing and joint extending to position in which ACL graft is the most vulnerable to strain this protecting function reaches the highest.

关 键 词：前交叉韧带 等速测试 髌韧带 韧带损伤 

分 类 号：R686.5[医药卫生—骨科学]