Sigurðsson Haraldur Björn, Fl Pétursdóttir Melkorka Katrín, Briem Kristín
Department of Physical Therapy, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Research Centre of Rehabilitation and Movement Science, University of Iceland, Reykjavik, Iceland.
Knee Surg Sports Traumatol Arthrosc. 2025 May;33(5):1677-1685. doi: 10.1002/ksa.12471. Epub 2024 Sep 12.
In this study, prospective data were used to evaluate whether the early peak knee abduction moment waveform is associated with the risk of anterior cruciate ligament (ACL) injury.
Biomechanical data from 84 athletes who participated in the study as adolescents were analysed after cross-referencing national health registry data to confirm ACL reconstruction in the subsequent years. The knee abduction moment waveform shape was obtained with cluster analysis for the first 100 ms of a cutting manoeuvre (1776 trials in total) and classified as either containing an early peak knee abduction moment or not, and the odds ratio for later ACL injury was then calculated. Additionally, discrete kinematic and kinetic variables were extracted, and tested against the risk of ACL injury using mixed model logistic regression.
Of 84 athletes, 8 (all female) sustained a total of 13 ACL injuries in the years after motion analysis data collection. Six clusters of knee abduction moment waveform shapes were identified. Two clusters containing 446 trials were classified as an early peak knee abduction waveform. This waveform was associated with a 7.2-fold increase in the risk of ACL injury (95% confidence interval: 2.4-24.6; p < 0.001). Of the kinematic and kinetic variables tested, only the knee abduction angle at initial contact was associated with an increased risk of ACL injury (p < 0.001).
This is the first study to confirm the association between the early peak knee abduction moment waveform and the risk of ACL injury. Using waveforms, instead of discrete peak values of the knee abduction moment, may better represent risky movement patterns. Replicating these findings in a larger cohort will support the use of this method to screen athletes for risk and guide targeted preventive interventions and their efficacy.
Level II.
在本研究中，前瞻性数据用于评估早期峰值膝关节外展力矩波形是否与前交叉韧带（ACL）损伤风险相关。
在交叉引用国家健康登记数据以确认后续几年的ACL重建后，对84名青少年时期参与研究的运动员的生物力学数据进行了分析。通过对一次切入动作的前100毫秒进行聚类分析（总共1776次试验）获得膝关节外展力矩波形形状，并将其分类为包含早期峰值膝关节外展力矩或不包含，然后计算后期ACL损伤的比值比。此外，提取离散的运动学和动力学变量，并使用混合模型逻辑回归针对ACL损伤风险进行测试。
在84名运动员中，8名（均为女性）在运动分析数据收集后的几年中共发生了13次ACL损伤。识别出六类膝关节外展力矩波形形状。包含446次试验的两类被分类为早期峰值膝关节外展波形。这种波形与ACL损伤风险增加7.2倍相关（95%置信区间：2.4 - 24.6；p < 0.001）。在测试的运动学和动力学变量中，只有初始接触时的膝关节外展角度与ACL损伤风险增加相关（p < 0.001）。
这是第一项证实早期峰值膝关节外展力矩波形与ACL损伤风险之间关联的研究。使用波形而非膝关节外展力矩的离散峰值可能更好地代表危险的运动模式。在更大的队列中重复这些发现将支持使用这种方法对运动员进行风险筛查，并指导有针对性的预防干预及其效果。
二级。
