前十字靱帯再建術後のスポーツ活動時における怖さの検討

Fear during Sports Activity after Anterior Cruciate Ligament Reconstruction

　抄録：ACL再建術後のスポーツ活動時に膝崩れを起こしそうな怖さについて検討を行った．対象は膝屈筋腱の多重折りを用いて行ったACL再建術後1年以上経過観察を行った180例である．男性97例，女性83例であり，平均観察期間は28.6カ月であった．スポーツ活動時に膝崩れを起こしそうな怖さがあるかの自覚症状と臨床所見との関係を検討した．スポーツ復帰は術後平均9.3カ月であり，復帰直後には66.1％の症例で怖さを自覚していた．復帰直後にスポーツ活動中の怖さを訴えた症例と訴えなかった症例ではKT-1000患健差，膝伸展筋力健側比，術前期間，復帰時期，術前のgiving wayの回数いずれにも統計学上の有意差は認められなかった．怖さを訴える症例は経過とともに減少し，術後平均28.6カ月の最終評価時には25.0％であった．KT-1000患健差2.5mm以上，pivot shift test陽性などの，安定性が十分ではない症例で怖さが残存する傾向が高かった．

　We evaluated the unstable feeling after anterior cruciate ligament reconstruction in 180 patients who had undergone ACL reconstruction with hamstring tendons and had been followed up for over a year. There were 97males and 83 females. We evaluated fear of their knee giving way during sports activity and the clinical results. The average interval between reconstruction and return sports activity was 9.3months, and 66.1％of the patients experienced fear during sports activity. After returning to sports, there were no significant differences between patients who experienced fear and who did not in terms of KT-1000 side-to-side difference, knee extension strength, preoperative period, or preoperative frequency of giving way. The number of patients who had experienced fear decreased after returning to sports, and 25.0％of the patients still experienced fear at the final follow-up. Strong risk factors for persistent fear during sports activity were：KT-1000 side-to-side difference over 2.5mm, positive pivot-shift test, and frequent giving way before surgery.