疲劳因素影响膝关节前交叉韧带的非接触性损伤生物力学

背景：膝关节前交叉韧带的损伤会触发膝关节的其他损伤，如慢性膝关节不稳，骨关节炎等。梳理非接触性膝关节前交叉韧带损伤有助于掌握损伤机制，降低损伤发病率。 目的：对膝关节前交叉韧带非接触性损伤的生物力学机制和疲劳落地有关的损伤及生物力学变化进行阐述，探究有关疲劳因素在跳跃-落地运动时前交叉韧带损伤的研究进展。 方法：由作者应用计算机检索PubMed数据库1988至2013年相关文献，在标题中以“ACL”、“landing”、“fatigue”等关键词检索，选择内容与膝关节前交叉韧带损伤的生物力学研究、疲劳落地与下肢损伤有关的文献，共纳入文献42篇。 结果与结论：跳跃落地时膝关节外翻角、力矩、膝关节旋外和落地时较小的膝关节屈曲角是造成非接触性膝关节前交叉韧带损伤产生的主要生物力学机制。疲劳因素是非接触性前交叉韧带损伤的另一个重要因素，但在跳跃-落地运动中，疲劳效应对膝关节交叉韧带的生物力学作用并不清晰。这可能是由于疲劳水平、疲劳诱导方式和动作控制方面的差异所导致。疲劳诱导是研究疲劳状态下膝关节前交叉韧带损伤的关键，因而，量化的疲劳水平、专项性的疲劳模型和落地方式可以为探究疲劳状态下膝关节前交叉韧带损伤生物力学机制提供新的思路，同时为损伤的干预和恢复提供借鉴。

Biomechanical progress of fatigue effect on non-contact anterior cruciate ligament injury

BACKGROUND：Anterior cruciate ligament injury can trigger knee instability, knee osteoarthritis which decreases human beings’ life quality. Exploration on non-contact anterior cruciate ligament injury mechanism can prevent the occurrence of anterior cruciate ligament injury. OBJECTIVE：To investigate the mechanism of fatigue effect on non-contact anterior cruciate ligament injury and to introduce the progression of fatigue effect on non-contact anterior cruciate ligament injury in jump-landing activities. METHODS：The author retrieved the PubMed database from 1988 to 2013 by computer. The key words were set as：ACL, landing, and fatigue. A total of 42 articles were included which related to biomechanics research on anterior cruciate ligament injury, fatigue landing and low-limb injury. RESULTS AND CONCLUSION：In jump-landing activities, knee valgus, moment, knee joint rotation and smal er knee flexion are main biomechanics underlying non-contact anterior cruciate ligament injury. In addition, fatigue effect is another critical factor for non-contact anterior cruciate ligament injury. However, the cause-effect＆nbsp;between fatigue effect and anterior cruciate ligament injury is not clearly investigated and summarized, especial y on fatigue level, fatigue induction and movement control. Introduction of fatigue induction is crucial for better understanding how fatigue effect results in anterior cruciate ligament injury. Thus, the quantification of fatigue level, fatigue models and landing ways wil provide new ideas for exploring biomechanical mechanism underlying anterior cruciate ligament injury in fatigue state, as wel as provide more information on intervention design and injury rehabilitation.