I. はじめに Anterior Cruciate Ligament; ACL Anterior Tibial Translation; ATT ACL ACL 1,2) 3) ACL anterior shear force Houck 4) ACL ACL Berchuck 5
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1 原著 9 1 Correlation of Knee Extension Moment during Walking with Anterior Tibial Translation at 1 Year after Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts 1,2) 3) 1) 1) 1) 1) 1) 1) 4) 4) YUTARO IKENO, RPT 1,2), SATOSHI TANAKA, RPT, PhD 3), EIJI YAMADA, RPT, PhD 1), WATARU FUKUDA, RPT, MS 1), YUSUKE KATAOKA, RPT 1), YUKA HAMANO, RPT 1), KENTA TAKEUCHI, RPT 1), SHOUHEI KAWAKAMI, RPT 1), TAISHI NINOMIYA, MD 4), NORIYUKI GOMI, MD, PhD 4) 1) Department of Physical Therapy in Affilation with a Center of Orthopaedic Surgery, The Taijyukai Foundation (social medical corporation) Kaisei General Hospital: Muro, Sakaide-shi, Kagawa , Japan. TEL yutaro_ikeno1986@yahoo.co.jp 2) Prefectural University of Hiroshima, Graduate School of Comprehensive Scientific Research 3) Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima 4) Center of Orthopaedic Surgery, The Taijyukai Foundation (Social Medical Corporation) Kaisei General Hospital Rigakuryoho Kagaku 30(2): , Submitted Oct. 17, Accepted Dec. 16, ABSTRACT: [Purpose] The relationship between the knee extension moment in the early walking stage at 9 weeks after anterior cruciate ligament (ACL) reconstruction surgery with hamstring tendon autografts (STG) on anterior tibial translation (ATT) at one year post-surgery were investigated to clarify the influence of knee extension moment on ligament reconstruction. [Subjects] Ten cases of ACL reconstruction using STG (20 limbs: 10 operated, 10 nonoperated). [Methods] The knee extension moment of the early walking stage at 9 weeks post-surgery was computed from 3D motion analysis data and ground reaction force, and normalized to body weight. At one year post-surgery ATT was determined. [Results] The knee extension moment at 9 weeks post surgery of the operated side showed a significantly lower value than that of the non-operated side, but it was not related to ATT at one year post-surgery. [Conclusion] To prevent secondary injury, improvement of the decreased knee extension moment in the early walking stage at 9 weeks after ACL reconstruction surgery is necessary. Key words: anterior cruciate ligament, knee extension moment, anterior tibial translation 要旨 : STG ACL 9 1 ATT STG ACL ATT ACL 9 キーワード : 1) : TEL ) 3) 4)
2 I. はじめに Anterior Cruciate Ligament; ACL Anterior Tibial Translation; ATT ACL ACL 1,2) 3) ACL anterior shear force Houck 4) ACL ACL Berchuck 5) Quadriceps Avoidance Gait; QAG ACL Knoll 6) Bone patellar tendon Bone; BTB ACL QAG ACL Webster 7) ACL BTB Semitendinosus and Gracilis tendon; STG STG BTB ATT 8) STG ACL 9 1 II. 対象と方法 1 STG ACL ACL 1 ACL ACL 2 ADL ACL ACL SONY DCR-HC7 60 Hz 1 AMTI-JAPAN AccuGait 60 Hz ToMoCo-VM FP 表 cm kg BMI kg/m ACL ACL mm BMI; Body Mass Index
3 表 2 ACL 1 1/3 2 1/2 3 2/ ToMoCo-VM 10 N 10N 5 ToMoCo-VM Intraclass correlation coefficient; ICC intra-class reliability; Hz 4 inter-class reliability; LED ICC ) 3 9) 11) m 1/3 5 11) mm ToMoCo-VM FP 3 ACL 1 4 KneeLax KNL 1 ATT 3 ACL Wilcoxon ATT Pearson
4 表 3 95 Nm/kg * Nm/kg *: p<0.01 mean SD IBM SPSS Statistics GRAD PACK version III. 結果 15 mm 3 Shapiro-Wilk ACL Nm/kg Nm/kg 3 1 ATT mm 1 ATT r=0.50 p=0.14 IV. 考察 ACL 8 ACL 12) ACL 13) Solomonow 14) ACL mechanoreceptor 15) ACL 1 ACL ACL 2 ATT ACL ACL 1 ATT 3,16) 17) 18) Barber 19) ACL 18) 3) ACL 9 1 ATT ACL 9 18) 4 LED 1/60 STG ACL 9 1 ACL 9 1 ATT ACL 9
5 引用文献 1) Finsterbush A, Frankle U, Matan Y, et al.: Secondary damage to the knee after isolated injury of the anterior cruciate ligament. Am J Sports Med, 1990, 18(5): ) : ACL (1): ) : ) Houck J, Yack HJ: Associations of knee angles, moments and function among subjects that are healthy and anterior cruciate ligament deficient (ACLD) during straight ahead and crossover cutting activities. Gait Posture, 2003, 18(1): ) Berchuck M, Andriacchi TP, Bach BR, et al.: Gait adaptations by patients who have a deficient anterior cruciate ligament. J Bone Joint Surg, 1990, 72(6): ) Knoll Z, Kiss RM, Kocsis L: Gait adaptation in ACL deficient patients before and after anterior cruciate ligament reconstruction surgery. J Electromyogr Kinesiol, 2004, 14(3): ) Webster KE, Wittwer JE, O Brien J, et al.: Gait patterns after anterior cruciate ligament reconstruction are related to graft type. Am J Sports Med, 2005, 33(2): ) Devita P, Hortobagyi T, Barrier J, et al.: Gait adaptations before and after anterior cruciate ligament reconstruction. Med Sci Sport Exerc, 1997, 29(7): ) (4): ). B : ) pp ) ACL MRI (3): ) (3): ) Solomonow M, Baratta R, Zhou BH, et al.: The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability. Am J Sports, 1987, 15(3): ) (5): ) Zabala ME, Favre J, Scanlan SF, et al: Three-dimensional knee moments of ACL reconstructed and control subjects during gait, stair ascent, and stair descent. J Biomech, 2013, 46(3): ) (4): ) 2010 pp ) Barber-Westin SD, Noyes FR, Heckmann TP, et al.: The effect of exercise and rehabilitation on anterior-posterior knee displacements after anterior cruciate ligament autograft reconstruction. Am J Sports Med, 1999, 27(1):
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