Background:Anterior cruciate ligament (ACL) injury is one of the most severe injuries for athletes. It is important to identify risk factors because a better understanding of injury causation can help inform athletes about risk and increase their understanding of and motivation for injury prevention.Purpose:To investigate the relationship between anatomic factors and risk for future noncontact ACL injuries.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 870, excluding 9 players with a new contact ACL injury and a player with a new noncontact ACL injury just before the testing, female elite handball and soccer players—86 of whom had a history of ACL injury—underwent measurements of anthropometrics, alignment, joint laxity, and mobility, including leg length, knee alignment, knee anteroposterior laxity, generalized joint hypermobility, genu recurvatum, and hip anteversion. All ACL injuries among the tested players were recorded prospectively. Welch t tests and chi-square tests were used for comparison between the groups (new injury group, which sustained a new ACL injury in the follow-up period, and no new injury group).Results:An overall 64 new noncontact ACL injuries were registered. No differences were found between athletes with and without a new ACL injury among most of the measured variables. However, static knee valgus was significantly higher in the new injury group than in the no new injury group among all players (mean difference [MD], 0.9°; P = .007), and this tendency was greater in players with a previous ACL injury (MD, 2.1°; P = .002). Players with secondary injury also had a higher degree of knee hyperextension when compared with those previously injured who did not have a secondary injury (MD, 1.6°; P = .007).Conclusion:The anatomic factors that we investigated had a weak or no association with risk for an index noncontact ACL injury. Increased static knee valgus was associated with an increased risk for noncontact ACL injury, in particular for secondary injury. Furthermore, hyperextension of the knee was a risk factor for secondary ACL injury.

中文翻译：

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初始和继发性非接触性前交叉韧带损伤的解剖危险因素：一项针对 880 名女性精英手球和足球运动员的前瞻性队列研究


背景： 前交叉韧带 （ACL） 损伤是运动员最严重的损伤之一。确定风险因素很重要，因为更好地了解受伤的因果关系有助于让运动员了解风险，并增加他们对受伤预防的理解和动机。目的： 探讨解剖学因素与未来非接触性 ACL 损伤风险之间的关系。研究设计： 队列研究;证据水平，2.方法： 共 870 例，不包括 9 例新发接触性 ACL 损伤的球员和一名检测前新发非接触性 ACL 损伤的球员，女子精英手球和足球运动员——其中 86 名有 ACL 损伤史——接受了人体测量学、对齐、关节松弛和活动度的测量，包括腿长， 膝关节力线、膝关节前后松弛、全身关节过度活动、膝内翻和髋关节前倾。前瞻性记录了受测球员的所有 ACL 损伤。采用 Welch t 检验和卡方检验进行组间比较 （新损伤组，随访期间发生新的 ACL 损伤，无新损伤组）。结果： 共记录了 64 例新的非接触性 ACL 损伤。在大多数测量变量中，有和没有新发 ACL 损伤的运动员之间没有发现差异。然而，在所有球员中，新损伤组的静态膝外翻显著高于无新损伤组（平均差 [MD]，0.9°;P = .007），并且这种趋势在既往 ACL 受伤的球员中更大 （MD，2.1°;P = .002）。与之前没有二次受伤的球员相比，二次受伤的球员也有更高程度的膝关节过度伸展（MD，1.6°;P = .007）。结论： 我们调查的解剖因素与指数非接触性 ACL 损伤的风险有较弱的相关性或无相关性。静态膝外翻增加与非接触性 ACL 损伤的风险增加相关，尤其是继发性损伤。此外，膝关节过度伸展是继发性 ACL 损伤的危险因素。