Hodel Sandro, Imhoff Florian B, Strutzenberger Gerda, Fitze Daniel, Obrist Simone, Vlachopoulos Lazaros, Scherr Johannes, Fucentese Sandro F, Fröhlich Stefan, Spörri Jörg
Department of Orthopaedics, Knee Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Department of Orthopaedics, Sports Medical Research Group, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2025 May;33(5):1560-1568. doi: 10.1002/ksa.12447. Epub 2024 Aug 27.
The aim of this study was to analyse sex-specific differences contributing to dynamic valgus in competitive soccer players before and after a standardised fatiguing protocol.
Thirty-nine healthy female and male competitive soccer players (19 females and 20 males) were recruited for the purpose of this study. Bilateral medial knee displacement (MKD) was assessed during drop jump landings using a three-dimensional motion capture system before and after a standardised fatiguing protocol. In addition, all soccer players underwent clinical examinations, including rotational hip range of motion (ROM), isokinetic strength testing and magnetic resonance imaging (MRI) of the hip and knee. Sex-specific and fatigue-dependent differences were reported, and the influence of demographic, clinical and radiographic factors on MKD was analysed via multiple linear regression models.
Compared with male soccer players, female soccer players demonstrated a tendency towards increased MKD during drop jump landings before (p = 0.09) and after the fatiguing protocol (p = 0.04). Sex-specific differences included increased hip internal rotation (IR) ROM, decreased hip external rotation (ER) strength and increased femoral torsion in females (all p < 0.002). According to the multiple linear regression models (stepwise method), increased hip IR ROM (90° of flexion) and the non-dominant leg remained the sole independent predictors of increased MKD during drop jump landings before (p < 0.01 and p = 0.02, respectively) and after fatigue (p < 0.01 and p < 0.01, respectively). An increase in hip IR ROM in females was linearly related to MKD after fatigue (R = 0.25; p < 0.01).
Female soccer players exhibited increased dynamic valgus before and after fatigue, which is likely attributed to joint mobility, as well as muscular and anatomical differences, such as increased hip IR ROM, reduced hip ER strength and increased femoral torsion. In particular, females with increased hip IR ROM were more susceptible to effects of fatigue on MKD, which may increase their risk for anterior cruciate ligament injury.
Level III.
本研究旨在分析在标准化疲劳方案前后，导致竞技足球运动员动态外翻的性别特异性差异。
本研究招募了39名健康的男女竞技足球运动员（19名女性和20名男性）。在标准化疲劳方案前后，使用三维运动捕捉系统在纵跳落地时评估双侧膝关节内侧位移（MKD）。此外，所有足球运动员都接受了临床检查，包括髋关节旋转活动范围（ROM）、等速肌力测试以及髋关节和膝关节的磁共振成像（MRI）。报告了性别特异性和疲劳依赖性差异，并通过多元线性回归模型分析了人口统计学、临床和影像学因素对MKD的影响。
与男性足球运动员相比，女性足球运动员在疲劳方案前（p = 0.09）和后（p = 0.04）的纵跳落地过程中表现出MKD增加的趋势。性别特异性差异包括女性髋关节内旋（IR）ROM增加、髋关节外旋（ER）力量降低和股骨扭转增加（所有p < 0.002）。根据多元线性回归模型（逐步法），髋关节IR ROM增加（屈曲90°）和非优势腿仍然是疲劳前（分别为p < 0.01和p = 0.02）和疲劳后（分别为p < 0.01和p < 0.01）纵跳落地时MKD增加的唯一独立预测因素。女性髋关节IR ROM增加与疲劳后MKD呈线性相关（R = 0.25；p < 0.01）。
女性足球运动员在疲劳前后均表现出动态外翻增加，这可能归因于关节活动度以及肌肉和解剖学差异，如髋关节IR ROM增加、髋关节ER力量降低和股骨扭转增加。特别是，髋关节IR ROM增加的女性更容易受到疲劳对MKD的影响，这可能会增加她们前交叉韧带损伤的风险。
三级。
