前交叉韧带重建 1 年和 3 年后,较高的等动股四头肌峰值力与患者可接受的症状状态有关。

IF 3.3 2区 医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-11-20 DOI:10.1002/ksa.12541
Farshad Ashnai, Roland Thomeé, Eric Hamrin Senorski, Susanne Beischer
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引用次数: 0

摘要

目的:主要目的是确定膝关节损伤和骨关节炎结果评分(KOOS)分量表中达到患者可接受症状状态(PASS)的绝对(QNm/kg)和相对(QLSI)等动伸膝(KE)力量的临界值,并确定不同年龄组在前交叉韧带重建(ACLR)后1年和3年的QNm/kg和QLSI与PASS之间的关系:PASS的定义是达到所有KOOS分量表的临界值。从康复登记中提取随访数据。根据初次 ACLR 时的年龄,将男性和女性患者分为两个年龄组:16-24 岁和 25-65 岁。计算了 QNm/kg 和 QLSI 临界值与达到 PASS 之间的比值比。利用曲线下面积(AUC)构建了接收者操作特征曲线,以确定 QNm/kg 和 QLSI 达到 PASS 的个体预测能力:1年和3年随访分析分别采用了755名和145名患者(女性=51%和52%;受伤前泰格纳活动度≥6=82%和74%)的结果。所有组别在 1 年随访中达到 QNm/kg 临界值(≥2.1 和 ≥2.7)的几率是达到 PASS 的 2.09 至 5.12 倍。在3年的随访中,在16-41岁的男性和女性中,≥3.4和≥2.6QNm/kg的临界值与患者达到PASS有关,其准确性可接受(AUC = 0.700-0.780):在 ACLR 术后 1 年,达到 KE 绝对力量临界值的男女和年龄组患者达到 PASS 的几率是临床相关几率的 2 到 5 倍。在前交叉韧带置换术后3年,16-24岁的男性和女性患者的绝对KE强度具有可接受的分辨能力:证据等级:三级。
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Higher isokinetic quadriceps peak force is associated with a patient-acceptable symptom-state 1 and 3 years after ACL reconstruction.

Purpose: The main purpose was to determine cut-off values for absolute (QNm/kg) and relative (QLSI) isokinetic knee extensor (KE) strength for achieving a patient-acceptable symptom state (PASS) in the Knee injury and Osteoarthritis Outcome Score (KOOS) subscales and for different age groups to determine the association between QNm/kg and QLSI and PASS, at 1 and 3 years after an anterior cruciate ligament reconstruction (ACLR).

Methods: PASS was defined as reaching cut-off values for all KOOS subscales. Data from follow-ups were extracted from a rehabilitation registry. Male and female patients were divided into two age groups based on their age at primary ACLR: 16-24 years and 25-65 years. Odds Ratios between the QNm/kg and QLSI cut-off values and achieving PASS were calculated. Receiver Operating Characteristic curves were constructed to determine the individual predictive capacity for achieving PASS of QNm/kg and of QLSI using the area under the curve (AUC).

Results: Results from 755 and 145 patients (females = 51% and 52%; preinjury Tegner Activity level ≥6 = 82% and 74%) were used in the 1- and 3-year follow-up analyses. Reaching the cut-off values for the QNm/kg, ranging between ≥2.1 and ≥2.7, entailed between 2.09 and 5.12 times the odds of achieving PASS, across all groups at the 1-year follow-up. At the 3-year follow-up, the cut-off values of ≥3.4 and ≥2.6QNm/kg were associated with patients achieving PASS with acceptable accuracy (AUC = 0.700-0.780) in 16-41 year-old males and females.

Conclusion: At 1 year after ACLR, patients of both sexes and age groups reaching cut-off values for absolute KE strength had two to five times the odds, that were clinically relevant, to achieve PASS. Acceptable discriminative capacity was found for the absolute KE strength among male and female patients 16-24 years old, at 3 years after ACLR.

Level of evidence: Level III.

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来源期刊
CiteScore
8.10
自引率
18.40%
发文量
418
审稿时长
2 months
期刊介绍: Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
期刊最新文献
Higher isokinetic quadriceps peak force is associated with a patient-acceptable symptom-state 1 and 3 years after ACL reconstruction. Adapting the Dejour classification of trochlear dysplasia from qualitative radiograph- and CT-based assessments to quantitative MRI-based measurements. Letter to the Editor concerning 'The Calf Raise App shows good concurrent validity compared with a linear encoder in measuring total concentric work': Let's not compare apples to oranges. Total knee arthroplasty: The need for better patient selection. Patient-reported outcome measures, the holy grail of outcome assessment: Are they powerful enough to show a difference in knee arthroplasty alignment? A call for more comprehensive and objective data collection.
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