非预期条件下前交叉韧带重建术后运动员侧切动作下肢运动生物力学特征

目的 量化非预期条件下前交叉韧带重建(anterior cruciate ligament reconstruction, ACLR)术后运动员侧切动作中膝关节生物力学特征,探讨运动员前交叉韧带(anterior cruciate ligament, ACL)损伤潜在风险。 方法 应用红外运动捕捉系统和三维测力台同步采集 30 名 ACLR 男性运动员在预期和非预期条件下侧切动作中健侧、患侧下肢运动学和动力学数据。 应用双因素方差分析对关节角度、关节力矩、地面反作用力( ground reaction force, GRF)等测试指标进行统计分析。 结果 患侧肢体的膝关节屈曲角度、外翻力矩和屈曲力矩显著低于健侧肢体,内旋力矩和胫骨前剪切力显著高于健侧肢体。 与预期条件相比,非预期条件下膝关节屈曲角度、内旋力矩、胫骨前剪切力显著增加。 患侧肢体膝关节外旋角度在预期和非预期条件下均显著高于健侧,非预期条件下健侧肢体侧向 GRF 和前后 GRF 显著小于预期条件,患侧肢体侧向 GRF 显著高于预期条件。 结论 ACLR 运动员进行侧切动作时,相比于健侧,患侧表现出较小的膝关节屈曲角度,较大的膝关节内旋力矩和胫骨前剪切力的生物力学特征,可能存在较大的 ACL 潜在损伤风险;在非预期条件下,ACLR 运动员双侧下肢均表现出膝关节内旋力矩增大,侧向 GRF 增大和胫骨前剪切力增大的生物力学特征,提示 ACL 潜在损伤风险不仅限于患侧,健侧下肢也应加强侧切动作中 ACL 损伤预防。

Biomechanical Characteristics of Lower Limb for Athletes with Anterior Cruciate Ligament Reconstruction During Side Cutting under Unanticipated Condition

Objective To quantify biomechanical characteristics of knee joints for athletes after anterior cruciate ligament reconstruction (ACLR) surgery during side cutting under unanticipated conditions, and to investigate the potential risk of anterior cruciate ligament (ACL) injury in athletes. Methods The infrared motion capture system and three-dimensional (3D) force platform were used to collect the kinematic and kinetic data of lower limbs of 30 male athletes with ACLR during side cutting under anticipated and unanticipated conditions. The angle, moment, ground reaction force (GRF) and other test parameters were analyzed statistically by using two-way ANOVA with repeated measures. Results The knee flexion angle, valgus moment and flexion moment of the affected limb were significantly lower than those of the healthy limb. The internal rotation moment and tibial anterior shear force of the affected limb were significantly higher than those of the healthy limb. Compared with the anticipated conditions, the knee flexion angle, internal rotation moment and tibial anterior shear force significantly increased under unanticipated conditions. The knee external rotation angle of the affected limb was significantly larger than that of the healthy limb under both anticipated and unanticipated conditions. Under unanticipated conditions, the lateral GRF and anterior-posterior GRF of the unaffected limb were significantly lower than those under anticipated conditions, and the lateral GRF of the affected limb was significantly higher than that under anticipated conditions. Conclusions Compared with the healthy limb, the affected limb of athletes with ACLR showed biomechanical characteristics of smaller knee flexion angle, larger knee internal rotation moment and anterior tibial shear force during side cutting, indicating that the affected limb might have a greate potential risk of ACL injury. Under unanticipated conditions, both lower limbs of athletes with ACLR showed biomechanical characteristics of increased knee internal rotation moment, lateral GRF and anterior tibial shear force, indicating that the potential risk of ACL injury is not limited to the affected limb, and ACL injury prevention should also be strengthened in healthy lower limb during side cutting.