The early peak knee abduction moment waveform is a novel risk factor predicting anterior cruciate ligament injury in young athletes: A prospective study.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-12 DOI:10.1002/ksa.12471

Haraldur Björn Sigurðsson,Melkorka Katrín Fl Pétursdóttir,Kristín Briem

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Abstract

PURPOSE 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. METHODS 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. RESULTS 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). CONCLUSION 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 OF EVIDENCE Level II.

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早期膝关节外展力矩峰值波形是预测年轻运动员前交叉韧带损伤的新风险因素：前瞻性研究。

目的在这项研究中，我们利用前瞻性数据来评估膝关节外展力矩的早期峰值波形是否与前十字韧带（ACL）损伤的风险有关。方法对84名青少年时期参与研究的运动员的生物力学数据进行分析，并与国家健康登记数据进行交叉比对，以确认其后几年的前十字韧带重建情况。通过聚类分析获得了切削动作（共 1776 次试验）前 100 毫秒的膝外展力矩波形，并将其分为包含或不包含早期峰值膝外展力矩，然后计算了以后前交叉韧带损伤的几率比例。此外，还提取了离散的运动学和动力学变量，并使用混合模型逻辑回归法对前交叉韧带损伤的风险进行了测试。结果在 84 名运动员中，有 8 人（均为女性）在运动分析数据收集后的几年内共遭受了 13 次前交叉韧带损伤。研究发现了六个膝关节外展力矩波形群。其中包含 446 次试验的两个群组被归类为膝关节外展早期峰值波形。这种波形与前交叉韧带损伤风险增加 7.2 倍有关（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外展角度与前交叉韧带损伤风险增加有关（p < 0.001）。使用波形，而不是膝关节外展力矩的离散峰值，可以更好地代表有风险的运动模式。在更大的群体中复制这些研究结果将有助于使用这种方法筛查运动员的风险，并指导有针对性的预防干预措施及其效果。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).