Department of Kinesiology and Health, Georgia State University, Atlanta, Georgia, USA.
Department of Epidemiology, The University of North Carolina, Chapel Hill, North Carolina, USA.
Br J Sports Med. 2015 Feb;49(3):188-95. doi: 10.1136/bjsports-2013-092982. Epub 2014 Feb 21.
Information as to how anterior cruciate ligament (ACL) injury and reconstructive surgery (ACLR) alter lower extremity biomechanics may improve rehabilitation and return to play guidelines, reducing the risk for repeat ACL injury.
To compare lower extremity biomechanics before ACL injury and after subsequent ACLR for the injured and uninjured leg.
Baseline unilateral lower extremity biomechanics were collected on the dominant leg of participants without ACL injury when they entered the Joint Undertaking to Monitor and Prevent ACL (JUMP-ACL) study. Thirty-one participants with subsequent ACL injury, reconstructive surgery and full return to physical activity completed repeat, follow-up biomechanical testing, as did 39 uninjured, matched controls. Not all injured participants suffered injury to the dominant leg, requiring separation of those with ACL injury into two groups: ACLR-injured leg group (n=12) and ACLR-uninjured leg group (n=19). We compared the landing biomechanics of these three groups (ACLR-injured leg, ACLR-uninjured leg, control) before ACL injury (baseline) with biomechanics after ACL injury, surgery and return to physical activity (follow-up).
ACL injury and ACLR altered lower extremity biomechanics, as both ACLR groups demonstrated increases in frontal plane movement (increased hip adduction and knee valgus). The ACLR-injured leg group also exhibited decreased sagittal plane loading (decreased anterior tibial shear force, knee extension moment and hip flexion moment). No high-risk biomechanical changes were observed in control group participants.
ACL injury and ACLR caused movement pattern alterations of the injured and uninjured leg that have previously shown to increase the risk for future non-contact ACL injury.
了解前交叉韧带（ACL）损伤和重建手术（ACLR）如何改变下肢生物力学特性，可能会改进康复和重返赛场的指导原则，降低ACL 再次损伤的风险。
比较 ACL 损伤前和 ACLR 后受伤和未受伤下肢的下肢生物力学特性。
当参与者没有 ACL 损伤时，他们进入联合监测和预防 ACL 研究（JUMP-ACL）时，收集了其优势腿的基线单侧下肢生物力学数据。31 名随后发生 ACL 损伤、重建手术和完全恢复身体活动的参与者完成了重复的后续生物力学测试，39 名未受伤的匹配对照者也完成了测试。并非所有受伤的参与者都在优势腿受伤，因此需要将 ACL 损伤的参与者分为两组：ACL 重建损伤腿组（n=12）和 ACL 重建未损伤腿组（n=19）。我们比较了这三组（ACL 重建损伤腿、ACL 重建未损伤腿、对照组）在 ACL 损伤前（基线）和 ACL 损伤、手术后和恢复身体活动后的着陆生物力学特性。
ACL 损伤和 ACLR 改变了下肢生物力学特性，因为 ACLR 两组均表现出额状面运动增加（髋关节内收和膝关节外翻增加）。ACL 重建损伤腿组还表现出矢状面负荷减少（前胫骨剪切力、膝关节伸展力矩和髋关节屈曲力矩减少）。对照组参与者未观察到高风险的生物力学变化。
ACL 损伤和 ACLR 导致受伤和未受伤腿的运动模式改变，这些改变以前已被证明会增加未来非接触性 ACL 损伤的风险。
