Herbst Kristen A, Barber Foss Kim D, Fader Lauren, Hewett Timothy E, Witvrouw Erik, Stanfield Denver, Myer Gregory D
Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Wellington Orthopaedic and Sports Medicine, Cincinnati, Ohio, USA Mercy Hospital Anderson/University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Division of Health Sciences, Department of Athletic Training, College of Mount St Joseph, Cincinnati, Ohio, USA.
Am J Sports Med. 2015 Nov;43(11):2747-52. doi: 10.1177/0363546515599628. Epub 2015 Sep 1.
Hip and knee strength abnormalities have been implicated in patellofemoral pain (PFP) in multiple studies. However, the relationship is unclear, as many of these studies have been retrospective.
To compare prospective hip and knee isokinetic strength in young female athletes who subsequently went on to develop PFP relative to their uninjured, healthy peers.
Descriptive epidemiology study.
Adolescent female athletes (N = 329) were tested for isokinetic strength of the knee (flexion and extension) and hip (abduction) and screened for the prevalence of PFP before their basketball seasons. After exclusion based on current PFP symptoms, 255 participants were prospectively enrolled in the study. A 1-way analysis of variance was used to determine between-group differences in incident PFP and the referent (no incident PFP) participants.
The cumulative incidence rate for the development of PFP was 0.97 per 1000 athlete-exposures. Female athletes who developed PFP demonstrated increased normalized hip abduction strength (normalized torque, 0.013 ± 0.003) relative to the referent control group (normalized torque, 0.011 ± 0.003) (P < .05). Unlike hip strength, normalized knee extension and knee flexion strength were not different between the 2 groups (P > .05).
The findings in this study indicate that young female athletes with greater hip abduction strength may be at an increased risk for the development of PFP. Previous studies that have looked at biomechanics indicated that those with PFP have greater hip adduction dynamic mechanics.
Combining the study data with previous literature, we theorize that greater hip abduction strength may be a resultant symptom of increased eccentric loading of the hip abductors associated with increased dynamic valgus biomechanics, demonstrated to underlie increased PFP incidence. Further research is needed to verify the proposed mechanistic link to the incidence of PFP.
多项研究表明，髋部和膝部力量异常与髌股疼痛（PFP）有关。然而，由于许多此类研究都是回顾性的，这种关系尚不清楚。
比较年轻女性运动员中随后发展为PFP的人群与未受伤的健康同龄人之间的前瞻性髋部和膝部等速肌力。
描述性流行病学研究。
在青少年女性运动员（N = 329）的篮球赛季开始前，对其膝部（屈伸）和髋部（外展）的等速肌力进行测试，并筛查PFP的患病率。根据当前PFP症状排除后，255名参与者被前瞻性纳入研究。采用单因素方差分析来确定发生PFP的参与者与参照组（未发生PFP）之间的组间差异。
PFP发生的累积发病率为每1000运动员暴露人次0.97例。与参照对照组（标准化扭矩，0.011±0.003）相比，发生PFP的女性运动员表现出更高的标准化髋外展力量（标准化扭矩，0.013±0.003）（P <.05）。与髋部力量不同，两组之间的标准化膝伸展和膝屈曲力量没有差异（P>.05）。
本研究结果表明，髋外展力量较大的年轻女性运动员发生PFP的风险可能更高。以往关于生物力学的研究表明，患有PFP的人具有更大的髋内收动态力学。
将研究数据与以往文献相结合，我们推测更大的髋外展力量可能是与动态外翻生物力学增加相关的髋外展肌离心负荷增加的结果，这已被证明是PFP发病率增加的基础。需要进一步的研究来验证所提出的与PFP发病率的机制联系。
