Carlson Victor R, Sheehan Frances T, Boden Barry P
Functional and Applied Biomechanics, National Institutes of Health, Bethesda, Maryland.
The Orthopaedic Center, a Division of CAO, Rockville, Maryland.
JBJS Rev. 2016 Nov 29;4(11):e5. doi: 10.2106/JBJS.RVW.15.00116.
As the most viable method for investigating in vivo anterior cruciate ligament (ACL) rupture, video analysis is critical for understanding ACL injury mechanisms and advancing preventative training programs. Despite the limited number of published studies involving video analysis, much has been gained through evaluating actual injury scenarios.
Studies meeting criteria for this systematic review were collected by performing a broad search of the ACL literature with use of variations and combinations of video recordings and ACL injuries. Both descriptive and analytical studies were included.
Descriptive studies have identified specific conditions that increase the likelihood of an ACL injury. These conditions include close proximity to opposing players or other perturbations, high shoe-surface friction, and landing on the heel or the flat portion of the foot. Analytical studies have identified high-risk joint angles on landing, such as a combination of decreased ankle plantar flexion, decreased knee flexion, and increased hip flexion.
The high-risk landing position appears to influence the likelihood of ACL injury to a much greater extent than inherent risk factors. As such, on the basis of the results of video analysis, preventative training should be applied broadly. Kinematic data from video analysis have provided insights into the dominant forces that are responsible for the injury (i.e., axial compression with potential contributions from quadriceps contraction and valgus loading). With the advances in video technology currently underway, video analysis will likely lead to enhanced understanding of non-contact ACL injury.
作为研究体内前交叉韧带（ACL）断裂最可行的方法，视频分析对于理解ACL损伤机制和推进预防性训练计划至关重要。尽管涉及视频分析的已发表研究数量有限，但通过评估实际损伤场景已取得了很多成果。
通过使用视频记录和ACL损伤的变体及组合对ACL文献进行广泛检索，收集符合本系统评价标准的研究。描述性研究和分析性研究均被纳入。
描述性研究已确定了增加ACL损伤可能性的特定条件。这些条件包括靠近对方球员或其他干扰、鞋底与地面摩擦力大以及足跟或足底平部着地。分析性研究已确定着陆时的高危关节角度，如踝关节跖屈减少、膝关节屈曲减少和髋关节屈曲增加的组合。
高危着陆姿势似乎比内在风险因素在更大程度上影响ACL损伤的可能性。因此，基于视频分析结果，预防性训练应广泛应用。视频分析的运动学数据为导致损伤的主要力量（即轴向压缩，股四头肌收缩和外翻负荷可能起作用）提供了见解。随着当前视频技术的进步，视频分析可能会增强对非接触性ACL损伤的理解。
