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膝关节松弛度和侧向单腿跳测试中的左右差异可能使竞技青少年高山滑雪者更容易发生前交叉韧带再次损伤。

Side-to-side differences in knee laxity and side hop test may predispose an anterior cruciate ligament reinjury in competitive adolescent alpine skiers.

作者信息

Westin Maria, Mirbach Lisbeth I, Harringe Marita L

机构信息

Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden.

Aleris Sports Medicine and Ortopedi, Sabbatsbergs Hospital, Stockholm, Sweden.

出版信息

Front Sports Act Living. 2022 Oct 14;4:961408. doi: 10.3389/fspor.2022.961408. eCollection 2022.

Abstract

An anterior cruciate ligament (ACL) injury is a common, severe injury in alpine skiing, and anterior cruciate ligament reconstruction (ACLR) is frequently performed in competitive alpine skiers younger than 20 years old. To reduce the reinjury rate, both intrinsic and extrinsic risk factors should be examined. The aim of this study was to investigate possible intrinsic risk factors for an ACL reinjury in competitive alpine skiers. A cohort of 384 alpine skiers (191 males/193 females) from the Swedish ski high schools were prospectively followed during their high school years. The students were clinically examined and physically tested prior to each ski season. In addition, the RAND 36-Item health survey 1.0 (SF-36, Copyright 1994 Medical Outcome Trust, distributed by RAND Corporation) and injuries were prospectively registered. Thirty-one of the skiers (five males/26 females) had undergone an ACLR before entering the ski high school. This cohort was analyzed with respect to the occurrence of, and possible risk factors for an ACL reinjury (including ipsilateral and contralateral ACL injuries). Skiers who sustained an ACL reinjury were called the "ACL reinjury group," and those who did not sustain an ACL reinjury were called the "ACL injury group." Notably, 12 of the 31 students (39%), ten female and two male skiers, aged 16.5 (SD 0.5) years, sustained an ACL reinjury during the two first years at the ski high school. In addition, 10 of the 12 ACL reinjuries occurred within 10-23 months from the first injury [m 14.8 (SD4.7)] and two ACL reinjuries occurred at 29 and 47 months, respectively, from the first injury. It is noted that eight of the ACL reinjuries were to the ipsilateral knee and four to the contralateral knee. There were no differences between the groups with respect to muscle flexibility in the lower extremity, Beighton score, and one leg hop for distance or square hop test. Side-to-side differences were found with respect to knee joint laxity, >3 mm, measured with KT-1000 arthrometer ( = ), and the side hop test ( = ). RAND 36-Item health survey did not predict an ACL reinjury. In conclusion, a side-to-side difference in the side hop test and knee joint laxity (KT-1000) may predispose an ACL reinjury in competitive adolescent alpine skiers.

摘要

前交叉韧带(ACL)损伤是高山滑雪中常见的严重损伤,前交叉韧带重建术(ACLR)在20岁以下的竞技高山滑雪运动员中经常进行。为了降低再损伤率,应检查内在和外在风险因素。本研究的目的是调查竞技高山滑雪运动员ACL再损伤可能的内在风险因素。对来自瑞典滑雪高中的384名高山滑雪运动员(191名男性/193名女性)在高中期间进行了前瞻性随访。在每个滑雪季节开始前,对学生进行临床检查和体能测试。此外,前瞻性记录了兰德36项健康调查1.0(SF - 36,版权所有1994年医疗结果信托基金,由兰德公司发行)和损伤情况。其中31名滑雪运动员(5名男性/26名女性)在进入滑雪高中之前已经接受了ACLR。对该队列进行了关于ACL再损伤(包括同侧和对侧ACL损伤)的发生情况及可能风险因素的分析。发生ACL再损伤的滑雪运动员被称为“ACL再损伤组”,未发生ACL再损伤的运动员被称为“ACL损伤组”。值得注意的是,31名学生中有12名(39%),即10名女滑雪运动员和2名男滑雪运动员,年龄为16.5(标准差0.5)岁,在滑雪高中的头两年发生了ACL再损伤。此外,12例ACL再损伤中有10例发生在首次损伤后的10 - 23个月内[平均14.8(标准差4.7)],另外2例ACL再损伤分别发生在首次损伤后的29个月和47个月。需要注意的是,8例ACL再损伤发生在同侧膝关节,4例发生在对侧膝关节。两组在下肢肌肉柔韧性、Beighton评分以及单腿跳远距离或四方跳测试方面没有差异。在用KT - 1000关节测量仪测量(=)时,膝关节松弛度>3 mm以及侧跳测试(=)方面发现了两侧差异。兰德36项健康调查未能预测ACL再损伤。总之,侧跳测试和膝关节松弛度(KT - 1000)的两侧差异可能使竞技青少年高山滑雪运动员易发生ACL再损伤。

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