McGill University Health Centre, Division of Orthopaedic Surgery, Montreal, Quebec, Canada.
McGill University, Faculty of Medicine, Montreal, Quebec, Canada.
Am J Sports Med. 2023 Mar;51(4):1059-1066. doi: 10.1177/03635465231151686. Epub 2023 Feb 15.
Knee kinematic parameters during a drop vertical jump (DVJ) have been demonstrated to be associated with increased risk of noncontact anterior cruciate ligament (ACL) injury. However, standard motion analysis systems are not practical for routine screening. Affordable and practical motion sensor alternatives exist but require further validation in the context of ACL injury risk assessment.
PURPOSE/HYPOTHESIS: To prospectively study DVJ parameters as predictors of noncontact ACL injury in collegiate athletes using an affordable motion capture system (Kinect; Microsoft). We hypothesized that athletes who sustained noncontact ACL injury would have larger initial and peak contact coronal abduction angles and smaller peak flexion angles at the knee during a DVJ.
Case-control study; Level of evidence, 3.
102 participants were prospectively recruited from a collegiate varsity sports program. A total of 101 of the 102 athletes (99%) were followed for an entire season for noncontact ACL injury. Each athlete performed 3 DVJs, and the data were recorded using the motion capture system. Initial coronal, peak coronal, and peak sagittal angles of the knee were identified by our software.
Five of the 101 athletes sustained a noncontact ACL injury. Peak coronal angles were significantly greater and peak sagittal flexion angles were significantly smaller in ACL-injured athletes ( = .049, = .049, respectively). Receiver operating characteristic (ROC) analysis demonstrated an area under the curve of 0.88, 0.92, and 0.90 for initial coronal, peak coronal, and peak sagittal angle, respectively. An initial coronal angle cutoff of 2.96° demonstrated 80% sensitivity and 72% specificity, a peak coronal angle cutoff of 6.16° demonstrated 80% sensitivity and 72% specificity, and a peak sagittal flexion cutoff of 93.82° demonstrated 80% sensitivity and 74% specificity on the study cohort.
Increased peak coronal angle and decreased peak sagittal angle during a DVJ were significantly associated with increased risk for noncontact ACL injury. Based on ROC analysis, initial coronal angle showed good prognostic ability, whereas peak coronal angle and peak sagittal flexion provided excellent prognostic ability. Affordable motion capture systems show promise as cost-effective and practical options for large-scale ACL injury risk screening.
在垂直跳（DVJ）期间膝关节运动学参数已被证明与非接触性前交叉韧带（ACL）损伤的风险增加有关。然而，标准运动分析系统并不适用于常规筛查。目前已经有经济实惠且实用的运动传感器替代品，但在 ACL 损伤风险评估方面需要进一步验证。
目的/假设：本研究前瞻性地使用经济实惠的运动捕捉系统（Kinect；微软公司）研究 DVJ 参数作为大学生运动员非接触性 ACL 损伤的预测指标。我们假设发生非接触性 ACL 损伤的运动员在进行 DVJ 时，初始和峰值接触冠状外展角度更大，膝关节峰值屈曲角度更小。
病例对照研究；证据水平，3 级。
从大学校队体育项目中前瞻性招募了 102 名参与者。102 名运动员中有 101 名（99%）完成了整个赛季的非接触性 ACL 损伤随访。每位运动员进行 3 次 DVJ，数据使用运动捕捉系统记录。我们的软件确定了膝关节的初始冠状面、峰值冠状面和峰值矢状面角度。
101 名运动员中有 5 名发生了非接触性 ACL 损伤。ACL 损伤运动员的峰值冠状面角度显著更大，峰值矢状面屈曲角度显著更小（ =.049， =.049）。ROC 分析显示初始冠状面角度、峰值冠状面角度和峰值矢状面角度的曲线下面积分别为 0.88、0.92 和 0.90。初始冠状面角度截断值为 2.96°时，在研究队列中具有 80%的敏感性和 72%的特异性；峰值冠状面角度截断值为 6.16°时，具有 80%的敏感性和 72%的特异性；峰值矢状面屈曲截断值为 93.82°时，具有 80%的敏感性和 74%的特异性。
在 DVJ 过程中，冠状面角度增加和矢状面角度减小与非接触性 ACL 损伤的风险增加显著相关。基于 ROC 分析，初始冠状面角度显示出良好的预后能力，而峰值冠状面角度和峰值矢状面屈曲提供了极好的预后能力。经济实惠的运动捕捉系统作为一种具有成本效益且实用的 ACL 损伤风险筛查选择具有广阔前景。
