以KT-1000量測臺灣健康成人脛骨前移鬆弛度

Anterior Tibiofemoral Laxity Measured by KT-1000 Arthrometer in Healthy Adults

下肢的運動傷害中，前十字交叉韌帶（anterior cruciate ligament, ACL）拉傷的發生率很高，臨床上常使用KT-1000關節測量儀評估ACL受傷的程度。國外文獻顯示：若受傷膝腔骨被前拉的鬆弛度比健側>3 mm即表示ACL有被拉傷的可能。又根據過去的研究報告指出：肌腱、韌帶的鬆弛度會因運動量的不同而有差異，文獻上也指出東西方人的運動量是有不同，那麼西方人3 mm的標準值是否適用台灣人？又男女之問是否會有差異？本研究目的在了解台灣人ACL鬆弛度，以利未來臨床評估之參考。以KT-1000關節測量儀（arthrometer）為測量工具。從台大醫學院區內隨機選取99位 20-40歲健康成人男性60位，女性39位。以15、20、30磅拉力測量兩側脛骨前移值（anterior tibioremoral displacement）。15、20、30磅拉力下左膝脛骨前移之平均值依次為 2.5±1.1、3.4±1.3、4.7±1.5 mm；右膝為 2.9±1.2、4.1±1.6、6.0 ±2.2 mm。男性在15，20，30三種拉力下兩膝鬆弛度皆比女性小，且呈有意義差異（p＜.05）。國人膝關節脛脛骨可被前移的平均值是比外國人小。因此建議：評估男性的兩膝脛骨前移值若相差＞2 mm，女性若相差＞3 mm時，即應懷疑受傷側ACL鬆弛度過大，應進一步以核磁共振或關節鏡檢查確認。

It is very common to find anterior cruciate ligament (ACL) sprain or rupture in sports injuries. The severity of ligament injury was frequently evaluated using KT-1000 arthrometer in clinic. However, the past references showed that different amount of exercise results in different laxity of tendon and ligament. It also shows the different amount of exercise habit between western and eastern people. We wonder that whether the criteria value which was suspected ACL ligament lesion (more than 3 mm difference between sound knee and affected side) for western people is suitable to apply on the Taiwanese people. So the purpose of this study was to assess the measurement of anterior tibial displacement in Taiwanese people, therefore the anterior tibial displacement on the femur can be as an evaluation criteria to judge the patient need advanced physical examination or not. Ninety nine healthy adults were recruited from Medical College in National Taiwan University, age range between 20 and 40 years old. The measurement of bilateral anterior tibial displacements was assessed by KT-1000 arthrometer. The measurement of the anterior tibial displacements of the Taiwanese people, under 15, 20 and 30 pounds pulling forces, were 2.5±1.1, 3.4 ±1.3, and 4.7±1.5 mm of left knee and 2.9±1.2, 4.1±1.6, and 6.0 ± 2.2 of right knee, respectively. The average values of the anterior displacements were smaller for Taiwanese people than that of western people. The anterior laxities of knees under 15, 20 and 30 pounds in male were smaller than female and the difference was significant (p < .05 ). If the difference of anterior displacement between knees is greater than 2 mm in male and 3 mm in female, it should be ruled out ACL lesion and need advanced clinical examinations.