Warnecke Berit Flora, Richter Chris, King Enda, Paternoster Florian Kurt
Technical University of Munich, Munich, Germany.
Sports Surgery Clinic, Dublin, Ireland.
Orthop J Sports Med. 2024 Oct 9;12(10):23259671241276826. doi: 10.1177/23259671241276826. eCollection 2024 Oct.
Biomechanics and anterior cruciate ligament injury mechanisms differ in males and females. There is a need for more data on between-limb biomechanical differences after anterior cruciate ligament reconstruction (ACLR) in females.
To explore biomechanical asymmetries throughout the kinetic chain during the single-legged (SL) and double-legged (DL) countermovement jump (CMJ) and drop jump (DJ) in female athletes after ACLR.
Descriptive laboratory study.
Kinematic and kinetic between-limb differences were analyzed during the SL and DL CMJ and DJ in 67 female athletes 9 months after ACLR. Biomechanical and performance asymmetries between limbs during the jumps and isokinetic strength testing were analyzed with statistical parametric mapping. The entire stance phase was used for the paired tests of the biomechanical variables, with Cohen effect sizes of significant portions of the stance phase (reported as % of stance) calculated in a point-by-point manner.
Decreased vertical ground-reaction force, internal knee abduction moment, knee internal rotation angle, hip external rotation angle, internal ankle eversion, and external rotation moments were seen in the ACLR limb during all 4 vertical jump tests. The greatest number and highest value of differences were found during the DLDJ, with asymmetries having medium to large effect sizes. They tended to appear more frequently in the concentric phase (50% to 100% of stance) during the SLCMJ and DLCMJ and in the eccentric (0% to 49% of stance) and concentric (50% to 100% of stance) phase during the SLDJ and DLDJ. For the SLCMJ, SLDJ, and quadriceps strength, performance asymmetries of >15% were detected but not for change of direction.
The findings suggest that return-to-play testing in female athletes should examine the entire stance phase and include assessments of kinetic and kinematic variables throughout the kinetic chain. Greater deficits were highlighted in the DJ than in the CMJ, and greater performance asymmetries were evident in the SL tasks, with greater kinetic and kinematic and compensatory strategies evident in the DL tests.
Biomechanical analysis focusing on contralateral compensation strategies and sex-specific interventions are necessary before return to play.
男性和女性的生物力学及前交叉韧带损伤机制有所不同。对于女性前交叉韧带重建（ACLR）术后双下肢生物力学差异，需要更多数据。
探讨女性运动员ACLR术后单腿（SL）和双腿（DL）反向纵跳（CMJ）及下落跳（DJ）过程中整个动力链的生物力学不对称性。
描述性实验室研究。
对67名女性运动员ACLR术后9个月时的SL和DL CMJ及DJ过程中的运动学和动力学双下肢差异进行分析。采用统计参数映射分析跳跃过程中双下肢之间的生物力学和表现不对称性以及等速肌力测试。整个站立阶段用于生物力学变量的配对检验，以逐点方式计算站立阶段显著部分的科恩效应量（以站立百分比报告）。
在所有4项垂直跳跃测试中，ACLR侧下肢的垂直地面反作用力、膝关节内收力矩、膝关节内旋角度、髋关节外旋角度、踝关节内翻和外旋力矩均降低。在DL DJ过程中发现的差异数量最多且值最高，不对称性具有中等至较大的效应量。它们在SL CMJ和DL CMJ的向心阶段（站立的50%至100%）以及SL DJ和DL DJ的离心阶段（站立的0%至49%）和向心阶段（站立的50%至100%）出现的频率更高。对于SL CMJ、SL DJ和股四头肌力量，检测到>15%的表现不对称，但方向改变未检测到。
研究结果表明，女性运动员的重返赛场测试应检查整个站立阶段，并包括对整个动力链的动力学和运动学变量的评估。DJ中的缺陷比CMJ中更明显，SL任务中的表现不对称更明显，DL测试中动力学、运动学和代偿策略更明显。
在重返赛场之前，需要进行侧重于对侧代偿策略和性别特异性干预措施的生物力学分析。
