非接触性前交叉韧带损伤特点及机制的研究进展
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Review on the research of the mechanisms of non-contact ACL injuries
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    摘要:

    前交叉韧带断裂是膝关节最常见运动损伤之一,大部分是非接触性原因造成的。理解前交叉韧带受力和损伤机制对预防和治疗损伤有重要意义。本文综述了国内外对前交叉韧带损伤特点及其受力和损伤机制的研究结果。研究表明,下肢矢状面的生物力学是前交叉韧带受力的主要影响因素,如较小的膝关节屈角,较大的地面反作用力,较大的股四头肌力。其中较大的地面反作用力引发较大的股四头肌力和胫骨近端向前的拉力从而增加前交叉韧带负荷。较小的膝关节角合并较大的髌韧带与胫骨夹角和前交叉韧带倾斜角会增大韧带负荷。交叉韧带并不是承受膝关节内、外翻和内旋

    Abstract:

    Anterior cruciate ligament (ACL) tearing is one of the most commonly knee injuries in sports. Most ACL injuries in sports occur because of non-contact mechanisms. A better understanding of non-contact ACL injury characteristics as well as ACL loading and injury mechanisms is critical both for prevention and treatment of non-contact ACL injuries. This review summarized the researches on non-contact ACL injury characteristics, ACL loading and its injury mechanisms. The literatures demonstrated that sagittal plane biomechanical factors showed main affect on ACL loading, such as small knee flexion angle, great posterior ground reaction force, and great quadriceps muscle force. A great posterior ground reaction force is associated with a great quadriceps muscle force, which would cause a great anterior draw force at the proximal end of the tibia. A small knee flexion is associated with a large patella tendon-tibia shaft angle and ACL elevation angle, which would result in great ACL loading Current literature also demonstrates that ACL is not the major structure of bearing knee valgus-varus moment and internal rotation moment loadings. Knee valgus-varus moment and internal rotation moments alone are not likely to be the cause of ACL injuries without medial or lateral colletorial ligament injury as the most of non-contact ACL injuries clinically observed.

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刘卉,苏玉林,于冰.非接触性前交叉韧带损伤特点及机制的研究进展[J].医用生物力学,2008,23(3):240-247

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