Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases.
Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases.
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DOI：
10.1136/bjsports-2014-094573
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发表时间：
2015-11
影响因子：
18.4
通讯作者：
Hägglund M
中科院分区：
文献类型：
--
作者：
Waldén M;Krosshaug T;Bjørneboe J;Andersen TE;Faul O;Hägglund M
目前对男子足球运动员前交叉韧带（ACL）损伤机制的认识有限。采用系统录像分析方法描述男子职业足球运动员前交叉韧带损伤机制。我们评估了2001年至2011年期间通过前瞻性专业足球损伤监测记录的39例ACL完全撕裂的视频。五名分析员独立审查了所有视频，以估计足部与地面的初始接触时间和ACL撕裂时间。然后，我们根据描述受伤情况和下肢关节生物力学的结构化格式分析了所有视频。25人受伤是非接触性的，8人是间接接触性的，6人是直接接触性的。我们确定了三种主要的非接触性和间接接触性损伤情况：（1）按压（n=11），（2）踢后重新获得平衡（n=5）和（3）头球后落地（n=5）。第四种主要受伤情况是直接接触受伤的腿或膝盖（n=6）。膝关节外翻在非接触和间接接触的主要类别中常见（n=11），但动态外翻塌陷不常见（n=3）。这与所有病例（n=3）均发生膝外翻塌陷的牵引诱导直接接触情况相反。男性职业足球运动员中85%的ACL损伤是由非接触或间接接触机制造成的。最常见的导致受伤的比赛情况是压迫，其次是踢和头球。膝关节外翻是常见的，无论比赛的情况，但动态外翻崩溃是罕见的。
Current knowledge on anterior cruciate ligament (ACL) injury mechanisms in male football players is limited. To describe ACL injury mechanisms in male professional football players using systematic video analysis. We assessed videos from 39 complete ACL tears recorded via prospective professional football injury surveillance between 2001 and 2011. Five analysts independently reviewed all videos to estimate the time of initial foot contact with the ground and the time of ACL tear. We then analysed all videos according to a structured format describing the injury circumstances and lower limb joint biomechanics. Twenty-five injuries were non-contact, eight indirect contact and six direct contact injuries. We identified three main categories of non-contact and indirect contact injury situations: (1) pressing (n=11), (2) re-gaining balance after kicking (n=5) and (3) landing after heading (n=5). The fourth main injury situation was direct contact with the injured leg or knee (n=6). Knee valgus was frequently seen in the main categories of non-contact and indirect contact playing situations (n=11), but a dynamic valgus collapse was infrequent (n=3). This was in contrast to the tackling-induced direct contact situations where a knee valgus collapse occurred in all cases (n=3). Eighty-five per cent of the ACL injuries in male professional football players resulted from non-contact or indirect contact mechanisms. The most common playing situation leading to injury was pressing followed by kicking and heading. Knee valgus was frequently seen regardless of the playing situation, but a dynamic valgus collapse was rare.