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前交叉韧带重建术后运动员在单腿垂直跳高度对称的情况下,双侧垂直跳时下肢生物力学异常。

Abnormal Lower Limb Biomechanics During a Bilateral Vertical Jump Despite the Symmetry in Single-Leg Vertical Hop Height in Athletes After ACL Reconstruction.

作者信息

Chen Peng, Wang Ling, Dong Shiyu, Ding Yue, Zuo Huiwu, Jia Shaohui, Wang Guanglan, Chen Can, Zheng Cheng

机构信息

School of Exercise and Health, Shanghai University of Sport, Shanghai, China.

Key Laboratory of Sports Engineering of the General Administration of Sport of China, Wuhan Sports University, Wuhan, China.

出版信息

Orthop J Sports Med. 2024 Feb 27;12(2):23259671241230989. doi: 10.1177/23259671241230989. eCollection 2024 Feb.

Abstract

BACKGROUND

A limb symmetry index (LSI) of >90% for single-leg horizontal hop distance is recommended as a cutoff point for safe return to sports after anterior cruciate ligament reconstruction (ACLR). Despite achieving this threshold, abnormal lower limb biomechanics continue to persist in athletes after ACLR. Symmetry in single-leg vertical hop height appears to be more difficult to achieve and can be a better representation of knee function than single-leg horizontal hop distance.

PURPOSE

To explore whether an LSI of >90% for single-leg vertical hop height can represent normal lower limb biomechanics in athletes during a bilateral vertical jump after ACLR.

STUDY DESIGN

Controlled laboratory study.

METHODS

According to the LSI for single-leg vertical hop height, 46 athletes who had undergone ACLR with an autologous ipsilateral bone-patellar tendon-bone or hamstring tendon graft were divided into a low symmetry group (LSI <90%; n = 23) and a high symmetry group (LSI >90%; n = 23), and 24 noninjured athletes were selected as the control group. The kinematic and kinetic characteristics during a bilateral vertical jump were compared between the low symmetry, high symmetry, and control groups.

RESULTS

During the propulsion phase of the bilateral vertical jump, the operated side in the high symmetry group showed a lower knee extension moment than the nonoperated side ( = .001). At peak vertical ground-reaction force, the operated side in the high symmetry group showed a lower knee internal rotation moment compared with the control group ( = .016). Compared with the nonoperated side, the operated side in the high symmetry group showed a higher hip extension moment ( = .002), lower knee extension moment ( < .001), lower ankle plantarflexion moment ( < .001), and lower vertical ground-reaction force ( = .023).

CONCLUSION

Despite achieving an LSI of >90% for single-leg vertical hop height, athletes after ACLR showed abnormal lower limb biomechanical characteristics during the bilateral vertical jump.

CLINICAL RELEVANCE

Symmetrical single-leg vertical hop height may not signify ideal biomechanical or return-to-sports readiness in this population.

摘要

背景

单腿水平跳远距离的肢体对称指数(LSI)>90%被推荐作为前交叉韧带重建(ACLR)后安全重返运动的临界值。尽管达到了这个阈值,但ACLR后的运动员下肢生物力学仍持续异常。单腿垂直跳高度的对称性似乎更难实现,并且相比于单腿水平跳远距离,它能更好地反映膝关节功能。

目的

探讨单腿垂直跳高度的LSI>90%是否能代表ACLR后运动员在双侧垂直跳跃过程中的正常下肢生物力学。

研究设计

对照实验室研究。

方法

根据单腿垂直跳高度的LSI,将46例行自体同侧骨-髌腱-骨或腘绳肌腱移植的ACLR运动员分为低对称组(LSI<90%;n=23)和高对称组(LSI>90%;n=23),并选取24名未受伤运动员作为对照组。比较低对称组、高对称组和对照组在双侧垂直跳跃过程中的运动学和动力学特征。

结果

在双侧垂直跳跃的蹬伸阶段,高对称组的患侧膝关节伸展力矩低于健侧(P = 0.001)。在垂直地面反作用力峰值时,高对称组的患侧膝关节内旋力矩低于对照组(P = 0.016)。与健侧相比,高对称组的患侧髋关节伸展力矩更高(P = 0.002),膝关节伸展力矩更低(P < 0.001),踝关节跖屈力矩更低(P < 0.001),垂直地面反作用力更低(P = 0.023)。

结论

尽管单腿垂直跳高度的LSI>90%,但ACLR后的运动员在双侧垂直跳跃过程中仍表现出异常的下肢生物力学特征。

临床意义

在这一人群中,单腿垂直跳高度的对称性可能并不意味着理想的生物力学状态或具备重返运动的条件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2a6/10898320/c0853a7364fe/10.1177_23259671241230989-fig1.jpg

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