Nishida Kyohei, Xu Caiqi, Gale Tom, Anderst William, Fu Freddie
UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
J Orthop Res. 2022 Jan;40(1):239-251. doi: 10.1002/jor.25162. Epub 2021 Aug 19.
The objectives of this study were to determine symmetry and sex differences in knee kinematics and anterior cruciate ligament (ACL) elongation waveforms in healthy athletes without a history of a knee injury during fast running, drop jump, and 180° internal/external rotation hops. It was hypothesized that knee abduction angle and ACL relative elongation would be greater in women than in men during all activities. Bilateral knee kinematics and ACL relative elongation were determined in 19 collegiate athletes using dynamic biplane radiography. Sex differences in kinematics and ACL relative elongation waveforms were identified using statistical parametric mapping. Average absolute side-to-side differences (SSD ) in kinematics and ACL relative elongation waveforms were determined for each activity. Women had up to 2.3° (all p < 0.05) less knee adduction angle and had greater ACL relative elongation (max. 4.8%-9.2%; all p < 0.01) than men during all activities, in support of the hypotheses. SSD in kinematics were 1.4 mm and 5.5° or less in all components of translation and rotation, respectively, while SSD in ACL relative elongation was 3.6% or less across all activities. Greater ACL relative elongation across a variety of activities may make women more susceptible to ACL injury than men. This study provides valuable reference data for identifying abnormal asymmetry in knee kinematics and ACL elongation in athletes after the ACL injury. These novel results improve our understanding of ACL elongation during demanding athletic activities and may help guide the development of sex-specific risk screening metrics, return to play assessments, and rehabilitation protocols after the ACL injury.
本研究的目的是确定在快速跑步、单腿跳和180°内/外旋转单腿跳过程中，无膝关节损伤史的健康运动员的膝关节运动学和前交叉韧带（ACL）伸长波形的对称性及性别差异。研究假设在所有活动中，女性的膝关节外展角度和ACL相对伸长大于男性。使用动态双平面X射线摄影术测定了19名大学生运动员的双侧膝关节运动学和ACL相对伸长。使用统计参数映射识别运动学和ACL相对伸长波形中的性别差异。确定了每种活动中运动学和ACL相对伸长波形的平均绝对左右差异（SSD）。在所有活动中，女性的膝关节内收角度比男性小2.3°（所有p<0.05），且ACL相对伸长更大（最大4.8%-9.2%；所有p<0.01），支持了研究假设。运动学中的SSD在平移和旋转的所有分量中分别为1.4毫米和5.5°或更小，而ACL相对伸长的SSD在所有活动中为3.6%或更小。在各种活动中更大的ACL相对伸长可能使女性比男性更容易发生ACL损伤。本研究为识别ACL损伤后运动员膝关节运动学和ACL伸长的异常不对称提供了有价值的参考数据。这些新结果增进了我们对高强度体育活动中ACL伸长的理解，并可能有助于指导制定针对性别的风险筛查指标、重返比赛评估和ACL损伤后的康复方案。
