Background:

Individuals with anterior cruciate ligament (ACL) reconstruction (ACLR) are a population that has a higher risk for ACL injury compared with the general population. To reduce the reinjury rate and improve the rehabilitation outcome after ACLR, risk factors for ACL injury have to be addressed.

Purpose:

To compare the knee biomechanics during side-cutting and isokinetic strength of the thigh muscle of the reconstructed leg with those of the contralateral leg and healthy controls and investigate the knee movement asymmetries in individuals with ACLR.

Study Design:

Controlled laboratory study.

Methods:

A total of 16 participants with ACLR (ACLR group; 11.8 ± 1.1 months after reconstruction) and 16 healthy controls (control group) were recruited. Landmark coordinates and ground-reaction forces during side-cutting and isokinetic strength of hamstring and quadriceps were collected. Two-way analysis of variance with the mixed design was performed to compare each dependent variable between groups and across legs.

Results:

The reconstructed leg had a significantly smaller knee flexion angle (P = .004) and less quadriceps strength (P = .003) than the contralateral leg. The knee extension moment and knee external rotation angle were decreased compared with both the contralateral leg (P = .001, P = .003, respectively) and the healthy control leg (P = .001, P = .001, respectively). The ACLR group showed greater knee abduction angles (P = .004) and smaller knee external rotation moments (P = .006) than the control group. The ACLR group also demonstrated greater asymmetries of knee flexion angle (P = .015), knee external rotation angle (P = .001), knee extension moment (P = .013), knee abduction moment (P = .001), and quadriceps strength (P = .046) than the control group.

Conclusion:

Knee biomechanics in the leg with ACLR were altered mainly in the sagittal plane during side-cutting compared with the contralateral leg. The altered movement patterns between the ACLR and control groups were primarily observed in the frontal and transverse planes. The ACLR group also demonstrated greater asymmetries of sagittal knee movement and concentric quadriceps strength than the control group.

Clinical Relevance:

Individuals with ACLR showed different alterations in the reconstructed and contralateral leg compared with healthy controls. These results suggest that rehabilitation programs after ACLR should further focus on restoring the knee flexion angle and quadriceps strength. Injury prevention programs need to be further targeted in the altered movement patterns observed between the ACLR and the healthy groups.

中文翻译：

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单侧 ACL 重建后 1 年侧切过程中双侧等速力量和膝关节生物力学的变化

背景：

与普通人群相比，前交叉韧带 (ACL) 重建 (ACLR) 患者的 ACL 损伤风险更高。为了降低再损伤率并改善 ACLR 后的康复结果，必须解决 ACL 损伤的危险因素。

目的：

比较重建腿侧切过程中的膝关节生物力学和重建腿大腿肌肉的等速力量与对侧腿和健康对照组的情况，并调查 ACLR 个体的膝关节运动不对称性。

学习规划：

受控实验室研究。

方法：

共招募了 16 名 ACLR 参与者（ACLR 组；重建后 11.8 ± 1.1 个月）和 16 名健康对照组（对照组）。收集侧切过程中的地标坐标和地面反作用力以及腘绳肌和股四头肌的等速力量。使用混合设计进行双向方差分析，以比较组间和跨腿的每个因变量。

结果：

与对侧腿相比，重建腿的膝关节屈曲角度 ( P = .004) 和股四头肌力量 ( P = .003) 明显更小。与对侧腿（分别为P = .001、P = .003）和健康对照腿（分别为P = .001、P = .001）相比，膝关节伸展力矩和膝关节外旋角均有所降低。ACLR 组显示出比对照组更大的膝关节外展角 ( P = .004) 和更小的膝关节外旋力矩 ( P = .006)。ACLR 组的膝关节屈曲角度 ( P = .015)、膝关节外旋角度 ( P= .001)、膝关节伸展力矩 ( P = .013)、膝关节外展力矩 ( P = .001) 和股四头肌力量 ( P = .046) 均高于对照组。

结论：

与对侧腿相比，在侧切期间，ACLR 腿的膝关节生物力学主要在矢状平面发生改变。ACLR 和对照组之间运动模式的改变主要在正面和横向平面上观察到。ACLR 组也表现出比对照组更大的矢状膝运动和同心股四头肌力量的不对称性。

临床相关性：

与健康对照组相比，患有 ACLR 的个体在重建腿和对侧腿中表现出不同的变化。这些结果表明，ACLR 后的康复计划应进一步侧重于恢复膝关节屈曲角度和股四头肌力量。伤害预防计划需要进一步针对在 ACLR 和健康组之间观察到的运动模式改变。