L'Hermette Maxime, Coquart Jeremy, Senioris Antoine, Chamari Karim, Tourny Claire, Dujardin Franck
CETAPS-EA 3832, Faculty of Sport Sciences, University of Rouen, Mont Saint Aignan, France.
Orthopedic Surgery and Traumatology Department, Rouen Teaching Medical Center, Rouen, France.
Biol Sport. 2018 Jun;35(2):159-164. doi: 10.5114/biolsport.2018.72761. Epub 2018 Jan 24.
To identify the anterior cruciate ligament (ACL) laxity thresholds and to evaluate the utility of this measure in case of onset of knee injury for elite women handball players. Anterior laxity was measured by an arthrometer. Data on 29 elite women handball players and 20 sedentary women were collected. Among the handball group, 9 participants suffered from full-thickness ACL tears. The recorded variables were the anterior knee laxities at pressure load (PL) of 134 N (PL134N) and 250 N (PL250N) on the upper calf, which allowed assessment of the inter-leg comparison by calculating the differential laxity thresholds and the differential slope coefficients. Considering the healthy knee as a reference within the injured players, the laxity thresholds were identified, and the diagnostic value of the tests was assessed. The handball players without a full-thickness tear presented lower knee laxity than the sedentary women, and 75% were diagnosed with pathologic laxity in at least one of the knee joints, compared to 10% of sedentary women. The differential laxity threshold was identified between the handball players without a full-thickness tear and those with a full-thickness tear at 1.5 mm with PL134N and 2.2 mm with PL250N. The best diagnostic result was obtained using PL250N (area under the curve = 0.95). Handball practice is associated with specific laxities that are rarely seen in the general population. The ACL laxity thresholds may be useful measures to check the state of the ACL and to suggest full-thickness tears, as joint laxity appears to be a factor contributing to ACL tears in female handball players.
确定前交叉韧带（ACL）松弛阈值，并评估该测量方法在精英女子手球运动员膝关节损伤发病情况下的效用。通过关节测量仪测量前向松弛度。收集了29名精英女子手球运动员和20名久坐女性的数据。在手球组中，9名参与者患有全层ACL撕裂。记录的变量是小腿上部在134 N压力负荷（PL134N）和250 N压力负荷（PL250N）时的膝关节前向松弛度，通过计算差异松弛阈值和差异斜率系数可以评估双腿之间的比较情况。以受伤运动员中的健康膝关节作为参照，确定松弛阈值，并评估测试的诊断价值。没有全层撕裂的手球运动员的膝关节松弛度低于久坐女性，并且75%的人在至少一个膝关节中被诊断为病理性松弛，而久坐女性的这一比例为10%。在没有全层撕裂的手球运动员和全层撕裂的手球运动员之间，差异松弛阈值在PL134N时为1.5 mm，在PL250N时为2.2 mm。使用PL250N获得了最佳诊断结果（曲线下面积 = 0.95）。手球运动与一般人群中很少见的特定松弛度有关。ACL松弛阈值可能是检查ACL状态和提示全层撕裂的有用指标，因为关节松弛似乎是导致女性手球运动员ACL撕裂的一个因素。
