Nessler Trent, Denney Linda, Sampley Justin
Select Medical, 6712 Falls Ridge Lane, College Grove, TN, 37046, USA.
Northern Arizona University- Phoenix Biomedical Campus, 435 N. 5th St.- 6th Floor, Phoenix, AZ, 85004, USA.
Curr Rev Musculoskelet Med. 2017 Sep;10(3):281-288. doi: 10.1007/s12178-017-9416-5.
Mechanisms leading to anterior cruciate ligament (ACL) injury have been identified, yet re-injury or a secondary injury persists in the athletic population. The purpose of this review is to identify risk factors associated with ACL injury and investigate programs to prevent injury.
Faulty mechanics during dynamic movement that cause excessive valgus force at the knee increases the risk of ACL injury. Faulty mechanics may be a result of lateral displacement of the trunk, unequal limb loading, and lack of control to avoid the valgus knee position. Altered movements that place the ACL at risk are best identified in a fatigued state; however, could be recognized in a standard dynamic assessment. The faulty movement patterns are modifiable and should be addressed in an injury prevention program. Prevention programs include various modes of exercise such as plyometrics, neuromuscular training, and strength training. This review concludes that those programs which utilize neuromuscular training and strength training at a young age show the most promise in reducing ACL injuries. An ongoing thorough dynamic examination is necessary for all athletes while adjusting the intervention program in order to decrease the risk of ACL injury.
导致前交叉韧带（ACL）损伤的机制已被明确，但在运动员群体中，再次损伤或二次损伤仍持续存在。本综述的目的是确定与ACL损伤相关的危险因素，并研究预防损伤的方案。
动态运动过程中导致膝关节过度外翻力的错误力学机制会增加ACL损伤的风险。错误力学机制可能是由于躯干侧方移位、肢体负荷不均以及缺乏控制以避免膝关节外翻位置所致。使ACL处于危险中的异常动作在疲劳状态下最易被识别；然而，在标准动态评估中也可被识别。错误的运动模式是可改变的，应在预防损伤计划中加以解决。预防计划包括各种运动方式，如增强式训练、神经肌肉训练和力量训练。本综述得出结论，那些在年轻时采用神经肌肉训练和力量训练的计划在降低ACL损伤方面最具前景。对所有运动员进行持续彻底的动态检查，并调整干预计划，对于降低ACL损伤风险是必要的。
