Department of Orthopaedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Germany.
Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinik Hamburg, Hamburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2024 Nov;32(11):2840-2847. doi: 10.1002/ksa.12280. Epub 2024 May 30.
To analyse anterior cruciate ligament (ACL) rupture (ACLR) injury mechanisms in competitive judo using systematic video analysis, focusing on contact situations and biomechanics.
Seventeen videos of judo competitions wherein athletes developed ACLRs were included and retrospectively evaluated by five analysts. In all videos, the moment of initial contact and the index frame were defined. The judo techniques leading to the injury; the occurrence of direct contact, indirect contact or noncontact mechanisms; the time interval between the initial contact and index frame; the positions of the hip, knee and foot in relation to the initial contact and index frame; and the balance status during the initial contact and index frame were recorded.
Eleven (65%) of ACLRs in judo involved direct contact. The mean time interval between initial contact and index frame was 15 ± 22 ms. Thirteen (77%) athletes were not balanced at initial contact. In the index frame, the hip was abducted in all cases and in combination with internal rotation in 12 (71%) cases. From initial contact to index frame, hip flexion increased in all cases; at index frame, the knee joint was internally rotated relative to the trunk in 12 (71%) cases, and the knee flexion angles increased from the initial contact. In the index frame, the foot was externally rotated relative to the knee in 12 (71%) cases, and severe valgus development of the knee with valgus collapse was observed in 14 (82%) cases.
A direct attack on the knee was the most common injury mechanism observed. Valgus distortion appears to be the most important component of the mechanism of injury. With this knowledge, 'modified defence reactions' for specific judo techniques can be developed to reduce the injury risk.
Level IV.
使用系统视频分析分析竞技柔道中前交叉韧带（ACL）断裂（ACLR）损伤机制，重点关注接触情况和生物力学。
纳入 17 段柔道比赛视频，其中运动员发生 ACLR，并由 5 名分析师进行回顾性评估。在所有视频中，定义了初始接触时刻和索引帧。导致受伤的柔道技术；直接接触、间接接触或非接触机制的发生；初始接触和索引帧之间的时间间隔；髋关节、膝关节和足部相对于初始接触和索引帧的位置；以及初始接触和索引帧期间的平衡状态都被记录下来。
11 例（65%）柔道 ACLR 涉及直接接触。初始接触和索引帧之间的平均时间间隔为 15±22ms。13 例（77%）运动员在初始接触时不平衡。在索引帧中，所有情况下髋关节均外展，12 例（71%）情况下髋关节与内旋相结合。从初始接触到索引帧，髋关节屈曲增加；在索引帧中，膝关节相对于躯干内旋，12 例（71%）情况下膝关节屈曲角度从初始接触增加。在索引帧中，脚相对于膝盖向外旋转，12 例（71%）情况下观察到膝盖严重外翻，膝盖出现外翻塌陷。
直接攻击膝盖是观察到的最常见损伤机制。外翻扭曲似乎是损伤机制的最重要组成部分。有了这些知识，可以为特定的柔道技术开发“改良防御反应”，以降低受伤风险。
IV 级。
