Leppänen Mari, Pasanen Kati, Kujala Urho M, Vasankari Tommi, Kannus Pekka, Äyrämö Sami, Krosshaug Tron, Bahr Roald, Avela Janne, Perttunen Jarmo, Parkkari Jari
Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Am J Sports Med. 2017 Feb;45(2):386-393. doi: 10.1177/0363546516665810. Epub 2016 Oct 1.
Few prospective studies have investigated the biomechanical risk factors of anterior cruciate ligament (ACL) injury.
To investigate the relationship between biomechanical characteristics of vertical drop jump (VDJ) performance and the risk of ACL injury in young female basketball and floorball players.
Cohort study; Level of evidence, 3.
At baseline, a total of 171 female basketball and floorball players (age range, 12-21 years) participated in a VDJ test using 3-dimensional motion analysis. The following biomechanical variables were analyzed: (1) knee valgus angle at initial contact (IC), (2) peak knee abduction moment, (3) knee flexion angle at IC, (4) peak knee flexion angle, (5) peak vertical ground-reaction force (vGRF), and (6) medial knee displacement. All new ACL injuries, as well as match and training exposure, were then recorded for 1 to 3 years. Cox regression models were used to calculate hazard ratios (HRs) and 95% CIs.
Fifteen new ACL injuries occurred during the study period (0.2 injuries/1000 player-hours). Of the 6 factors considered, lower peak knee flexion angle (HR for each 10° increase in knee flexion angle, 0.55; 95% CI, 0.34-0.88) and higher peak vGRF (HR for each 100-N increase in vGRF, 1.26; 95% CI, 1.09-1.45) were the only factors associated with increased risk of ACL injury. A receiver operating characteristic (ROC) curve analysis showed an area under the curve of 0.6 for peak knee flexion and 0.7 for vGRF, indicating a failed-to-fair combined sensitivity and specificity of the test.
Stiff landings, with less knee flexion and greater vGRF, in a VDJ test were associated with increased risk of ACL injury among young female basketball and floorball players. However, although 2 factors (decreased peak knee flexion and increased vGRF) had significant associations with ACL injury risk, the ROC curve analyses revealed that these variables cannot be used for screening of athletes.
很少有前瞻性研究调查前交叉韧带（ACL）损伤的生物力学危险因素。
探讨年轻女性篮球和地板球运动员垂直纵跳（VDJ）表现的生物力学特征与ACL损伤风险之间的关系。
队列研究；证据等级，3级。
在基线时，共有171名女性篮球和地板球运动员（年龄范围12 - 21岁）参与了使用三维运动分析的VDJ测试。分析了以下生物力学变量：（1）初始接触（IC）时的膝外翻角度，（2）峰值膝外展力矩，（3）IC时的膝关节屈曲角度，（4）峰值膝关节屈曲角度，（5）峰值垂直地面反作用力（vGRF），以及（6）膝关节内侧位移。然后记录所有新的ACL损伤以及1至3年的比赛和训练暴露情况。使用Cox回归模型计算风险比（HRs）和95%置信区间（CIs）。
在研究期间发生了15例新的ACL损伤（0.2例损伤/1000运动员 - 小时）。在考虑的6个因素中，较低的峰值膝关节屈曲角度（膝关节屈曲角度每增加10°，HR为0.55；95% CI，0.34 - 0.88）和较高的峰值vGRF（vGRF每增加100 N，HR为1.26；95% CI，1.09 - 1.45）是与ACL损伤风险增加相关的唯一因素。受试者工作特征（ROC）曲线分析显示，峰值膝关节屈曲角度的曲线下面积为0.6，vGRF的曲线下面积为0.7，表明该测试的综合敏感性和特异性为中等。
在VDJ测试中，着陆僵硬，膝关节屈曲较少且vGRF较大，与年轻女性篮球和地板球运动员ACL损伤风险增加相关。然而，尽管两个因素（峰值膝关节屈曲减少和vGRF增加）与ACL损伤风险有显著关联，但ROC曲线分析显示这些变量不能用于筛查运动员。
