Department of Orthopaedics and Sports Medicine, Mercy Health St Elizabeth Youngstown Hospital, Youngstown, Ohio, USA.
Kerlan Jobe Institute at Cedars Sinai, Los Angeles, California, USA.
Am J Sports Med. 2018 Mar;46(4):862-868. doi: 10.1177/0363546518756328. Epub 2018 Feb 21.
Anterior cruciate ligament (ACL) injuries are prevalent in contact sports that feature cutting and pivoting, such as American football. These injuries typically require surgical treatment, can result in significant missed time from competition, and may have deleterious long-term effects on an athlete's playing career and health. While the majority of ACL tears in other sports have been shown to occur from a noncontact mechanism, it stands to reason that a significant number of ACL tears in American football would occur after contact, given the nature of the sport. Hypothesis/Purpose: The purpose was to describe the mechanism, playing situation, and lower extremity limb position associated with ACL injuries in professional American football players through video analysis to test the hypothesis that a majority of injuries occur via a contact mechanism.
Case series; Level of evidence, 4.
A retrospective cohort of National Football League (NFL) players with ACL injuries from 3 consecutive seasons (2013-2016) was populated by searching publicly available online databases and other traditional media sources. Of 156 ACL injuries identified, 77 occurred during the regular season and playoffs, with video analysis available for 69 injuries. The video of each injury was independently viewed by 2 reviewers to determine the nature of the injury (ie, whether it occurred via a noncontact mechanism), the position of the lower extremity, and the football activity at the time of injury. Playing surface, player position, and time that the injury occurred were also recorded.
Contrary to our hypothesis, the majority of ACL injuries occurred via a noncontact mechanism (50 of 69, 72.5%), with the exception of injury to offensive linemen, who had a noncontact mechanism in only 20% of injuries. For noncontact injuries, the most common football activity at the time of injury was pivoting/cutting, and the most common position of the injured extremity included hip abduction/flexion, early knee flexion/abduction, and foot abduction/external rotation. There was no association between injury mechanism and time of injury or playing surface in this cohort.
In this study of players in the NFL, the majority of ACL tears involved a noncontact mechanism, with the lower extremity exhibiting a dynamic valgus moment at the knee. These findings suggest that ACL injury prevention programs may reduce the risk of noncontact ACL tears in American football players.
前交叉韧带（ACL）损伤在涉及切割和旋转等接触性运动的项目中很常见，例如美式足球。这些损伤通常需要手术治疗，会导致运动员大量错过比赛时间，并且可能对运动员的比赛生涯和健康产生长期的不良影响。虽然其他运动项目中的大多数 ACL 撕裂都被认为是由非接触机制引起的，但考虑到该运动的性质，在美式足球中，相当数量的 ACL 撕裂应该是在接触后发生的。假设/目的：本研究旨在通过视频分析来描述职业美式足球运动员 ACL 损伤的机制、比赛情况和下肢肢体位置，以验证以下假设：大多数损伤是通过接触机制发生的。
病例系列；证据等级，4 级。
通过搜索公共在线数据库和其他传统媒体来源，确定了 3 个连续赛季（2013-2016 年）的 NFL 球员 ACL 损伤的回顾性队列。在 156 例 ACL 损伤中，有 77 例发生在常规赛和季后赛期间，其中 69 例有视频分析。每个损伤的视频均由 2 名审阅者独立观看，以确定损伤的性质（即是否由非接触机制引起）、下肢位置和损伤发生时的足球活动。还记录了比赛场地、球员位置和损伤发生时间。
与我们的假设相反，大多数 ACL 损伤是通过非接触机制（69 例中的 50 例，72.5%）引起的，除了进攻线锋的损伤，他们的非接触机制损伤仅占 20%。对于非接触性损伤，受伤时最常见的足球活动是旋转/切割，受伤肢体最常见的位置包括髋关节外展/屈曲、膝关节早期屈曲/外展和足部外展/外旋。在这个队列中，损伤机制与损伤发生时间或比赛场地之间没有关联。
在这项对 NFL 球员的研究中，大多数 ACL 撕裂涉及非接触机制，下肢在膝关节处表现出动态外翻力矩。这些发现表明，ACL 损伤预防计划可能会降低美式足球运动员非接触性 ACL 撕裂的风险。
