Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Am J Sports Med. 2024 Apr;52(5):1209-1219. doi: 10.1177/03635465241234255. Epub 2024 Mar 8.
An athlete who returns to sport after an anterior cruciate ligament (ACL) injury has a substantially high risk of sustaining a new secondary ACL injury. Because ACL injuries most frequently occur during cutting maneuvers, such movements should be at the center of research attention.
To investigate whether knee biomechanical parameters during side-step cutting maneuvers differ between female elite athletes with and without a history of ACL injury and to evaluate whether such parameters are associated with future secondary ACL injury.
Cohort study; Level of evidence, 2.
A total of 756 female elite handball and soccer players, of whom 76 had a history of ACL injury, performed a sport-specific cutting task while 3-dimensional kinematics and kinetics were measured. ACL injuries were registered prospectively over an 8-year follow-up period. Seven knee-specific biomechanical variables were the basis for all analyses. Two-way analyses of variance were applied to assess group differences, whereas logistic regression models served to evaluate associations between the knee-specific variables and future secondary ACL injury.
When players with a previous ACL injury performed the cutting maneuver with their ipsilateral leg, they exhibited lower knee abduction angles (mean difference [MD], 1.4°-1.5°; 95% CI, 0.2°-2.9°), lower peak knee flexion moments (MD, 0.33 N·m/kg; 95% CI, 0.18-0.48 N·m/kg), lower peak knee abduction moments (MD, 0.27 N·m/kg; 95% CI, 0.12-0.41 N·m/kg), and lower peak knee internal rotation moments (MD, 0.06 N·m/kg; 95% CI, 0.01-0.12 N·m/kg) compared with injury-free players. When players performed the cut with their contralateral leg, no differences were evident ( < .05). None of the 7 knee-specific biomechanical variables was associated with future secondary ACL injury in players with an ACL injury history ( < .05).
Approximately 4 years after ACL injury, female elite team-ball athletes still unloaded their ipsilateral knee during cutting maneuvers, yet contralateral knee loading was similar to that of injury-free players. Knee biomechanical characteristics were not associated with future secondary ACL injury.
前交叉韧带（ACL）损伤后重返运动的运动员有很高的再次发生 ACL 损伤的风险。因为 ACL 损伤最常发生在变向过程中，所以这种运动应该是研究的重点。
研究女性精英运动员中，有和没有 ACL 损伤史的运动员在侧步变向过程中膝关节生物力学参数是否不同，并评估这些参数是否与未来的 ACL 再损伤有关。
队列研究；证据水平，2 级。
共有 756 名女性精英手球和足球运动员参加了这项研究，其中 76 人有 ACL 损伤史。在 8 年的前瞻性随访期间，他们进行了一项特定于运动的变向任务，同时测量了 3 维运动学和动力学。ACL 损伤是通过前瞻性登记来记录的。双因素方差分析用于评估组间差异，而逻辑回归模型用于评估膝关节特定变量与未来 ACL 再损伤之间的关联。
当有 ACL 损伤史的运动员用其同侧腿进行变向时，他们的膝关节外展角度较低（平均差异[MD]，1.4°-1.5°；95%可信区间，0.2°-2.9°），峰值膝关节屈曲力矩较低（MD，0.33 N·m/kg；95%可信区间，0.18-0.48 N·m/kg），峰值膝关节外展力矩较低（MD，0.27 N·m/kg；95%可信区间，0.12-0.41 N·m/kg），峰值膝关节内旋力矩较低（MD，0.06 N·m/kg；95%可信区间，0.01-0.12 N·m/kg）。而当运动员用对侧腿进行变向时，则没有明显差异（<0.05）。在有 ACL 损伤史的运动员中，7 个膝关节特定生物力学变量中没有一个与未来的 ACL 再损伤相关（<0.05）。
ACL 损伤后大约 4 年，女性精英团队球类运动员在变向过程中仍对其同侧膝关节进行卸力，但对侧膝关节的受力与无损伤运动员相似。膝关节生物力学特征与未来的 ACL 再损伤无关。
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