Krosshaug Tron, Nakamae Atsuo, Boden Barry P, Engebretsen Lars, Smith Gerald, Slauterbeck James R, Hewett Timothy E, Bahr Roald
Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Am J Sports Med. 2007 Mar;35(3):359-67. doi: 10.1177/0363546506293899. Epub 2006 Nov 7.
The mechanisms of anterior cruciate ligament injury in basketball are not well defined.
To describe the mechanisms of anterior cruciate ligament injury in basketball based on videos of injury situations.
Case series; Level of evidence, 4.
Six international experts performed visual inspection analyses of 39 videos (17 male and 22 female players) of anterior cruciate ligament injury situations from high school, college, and professional basketball games. Two predefined time points were analyzed: initial ground contact and 50 milliseconds later. The analysts were asked to assess the playing situation, player behavior, and joint kinematics.
There was contact at the assumed time of injury in 11 of the 39 cases (5 male and 6 female players). Four of these cases were direct blows to the knee, all in men. Eleven of the 22 female cases were collisions, or the player was pushed by an opponent before the time of injury. The estimated time of injury, based on the group median, ranged from 17 to 50 milliseconds after initial ground contact. The mean knee flexion angle was higher in female than in male players, both at initial contact (15 degrees vs 9 degrees , P = .034) and at 50 milliseconds later (27 degrees vs 19 degrees , P = .042). Valgus knee collapse occurred more frequently in female players than in male players (relative risk, 5.3; P = .002).
Female players landed with significantly more knee and hip flexion and had a 5.3 times higher relative risk of sustaining a valgus collapse than did male players. Movement patterns were frequently perturbed by opponents.
Preventive programs to enhance knee control should focus on avoiding valgus motion and include distractions resembling those seen in match situations.
篮球运动中前交叉韧带损伤的机制尚未明确。
基于损伤情况的视频描述篮球运动中前交叉韧带损伤的机制。
病例系列；证据等级，4级。
6名国际专家对来自高中、大学和职业篮球比赛的39段前交叉韧带损伤情况的视频（17名男性和22名女性运动员）进行了视觉检查分析。分析了两个预先设定的时间点：初始地面接触时和50毫秒后。要求分析人员评估比赛情况、运动员行为和关节运动学。
39例中有11例（5名男性和6名女性运动员）在假定的损伤时间有接触。其中4例是对膝盖的直接打击，均为男性。22例女性病例中有11例是碰撞，或者运动员在受伤前被对手推搡。根据组中位数估计的损伤时间在初始地面接触后17至50毫秒之间。女性运动员在初始接触时（15度对9度，P = 0.034）和50毫秒后（27度对19度，P = 0.042）的平均膝关节屈曲角度均高于男性运动员。女性运动员比男性运动员更频繁地出现膝关节外翻塌陷（相对风险，5.3；P = 0.002）。
女性运动员落地时膝关节和髋关节屈曲明显更多，发生外翻塌陷的相对风险比男性运动员高5.3倍。运动模式经常受到对手的干扰。
增强膝关节控制的预防方案应侧重于避免外翻运动，并包括类似于比赛中出现的干扰因素。
