Hébert-Losier Kim, Schelin Lina, Tengman Eva, Strong Andrew, Häger Charlotte K
The University of Waikato, Faculty of Health, Sport and Human Performance, Adams Centre for High Performance, 52 Miro Street, Mount Maunganui, Tauranga 3116, New Zealand.
Umeå University, Department of Statistics, Umeå School of Business and Economics, 901 87 Umeå, Sweden.
Knee. 2018 Mar;25(2):226-239. doi: 10.1016/j.knee.2017.12.005. Epub 2018 Mar 7.
Anterior cruciate ligament (ACL) ruptures may lead to knee dysfunctions later in life. Single-leg tasks are often evaluated, but bilateral movements may also be compromised. Our aim was to use curve analyses to examine double-leg drop-jump kinematics in ACL-reconstructed, ACL-deficient, and healthy-knee cohorts.
Subjects with unilateral ACL ruptures treated more than two decades ago (17-28years) conservatively with physiotherapy (ACL, n=26) or in combination with reconstructive surgery (ACL, n=28) and healthy-knee controls (n=25) performed 40-cm drop-jumps. Three-dimensional knee, hip, and trunk kinematics were analyzed during Rebound, Flight, and Landing phases. Curves were time-normalized and compared between groups (injured and non-injured legs of ACL and ACL vs. non-dominant and dominant legs of controls) and within groups (between legs) using functional analysis of variance methods.
Compared to controls, ACL groups exhibited less knee and hip flexion on both legs during Rebound and greater knee external rotation on their injured leg at the start of Rebound and Landing. ACL also showed less trunk flexion during Rebound. Between-leg differences were observed in ACL only, with the injured leg more internally rotated at the hip. Overall, kinematic curves were similar between ACL and ACL. However, compared to controls, deviations spanned a greater proportion of the drop-jump movement at the hip in ACL and at the knee in ACL.
Trunk and bilateral leg kinematics during double-leg drop-jumps are still compromised long after ACL-rupture care, independent of treatment. Curve analyses indicate the presence of distinct compensatory mechanisms in ACL and ACL compared to controls.
前交叉韧带（ACL）断裂可能会导致日后出现膝关节功能障碍。单腿任务常被评估，但双腿运动也可能受到影响。我们的目的是通过曲线分析来研究ACL重建组、ACL缺失组和健康膝关节组的双腿纵跳运动学。
二十多年前（17 - 28岁）接受保守物理治疗（ACL组，n = 26）或联合重建手术治疗（ACL组，n = 28）的单侧ACL断裂患者以及健康膝关节对照组（n = 25）进行40厘米纵跳。在反弹、腾空和着陆阶段分析三维膝关节、髋关节和躯干运动学。对曲线进行时间归一化处理，并使用方差分析方法在组间（ACL组的受伤腿和未受伤腿与对照组的非优势腿和优势腿之间）以及组内（双腿之间）进行比较。
与对照组相比，ACL组在反弹过程中双腿的膝关节和髋关节屈曲程度较小，且在反弹开始和着陆时受伤腿的膝关节外旋角度更大。ACL组在反弹过程中的躯干屈曲程度也较小。仅在ACL组中观察到双腿之间的差异，受伤腿的髋关节内旋角度更大。总体而言，ACL组和ACL组的运动学曲线相似。然而，与对照组相比，ACL组在髋关节处以及ACL组在膝关节处的偏差在纵跳运动中所占比例更大。
在ACL断裂治疗后很长时间，双腿纵跳过程中的躯干和双侧腿部运动学仍然受到影响，与治疗方式无关。曲线分析表明，与对照组相比，ACL组和ACL组存在明显的代偿机制。
