运动导致前交叉韧带损伤的情境：系统综述与Meta分析
简介
本研究通过系统综述与荟萃分析，对1551例经视频验证的运动中ACL损伤案例进行分析，旨在明确不同运动项目中导致损伤的具体情境与动作模式。关键发现：非接触性机制最常见（n=745），其中以变向（53.8%）、压迫/抢断（50.2%）、减速（38.9%）和落地（30.1%）为主要动作；间接接触性损伤中，被抢断（56.1%）最常见。损伤多发生在高速水平移动（53.…
英文摘要
BACKGROUND: Anterior cruciate ligament (ACL) injuries are common in many sports and impose substantial performance and long-term health burdens. A quantitative synthesis of real-world, video-identified game situations can inform sport-specific prevention methods. OBJECTIVE: The aim of the study was to identify game situations and movement patterns leading to ACL injury in different sports. DESIGN: Systematic review with meta-analysis. DATA SOURCES: PubMed, Google Scholar, Web of Science, and Scopus were searched for studies analyzing video recordings of ACL injuries sustained by athletes of any sex during training or competition. Random effects meta-analyses of prevalence and moderator analyses (sport as a factor) were performed. RESULTS: In total, 39 articles (1551 video-verified ACL injuries) of on-average moderate quality (Quality Appraisal for Sports Injury Video Analysis Studies [QA-SIVAS]) scale mean 66%) were included. Noncontact (n = 745), indirect contact (n = 533), and direct contact (n = 273) mechanisms were reported, with notable sport-specific differences. Across all injuries, the most frequent contexts were ball action (45.7%), pressing/tackling (40.9%), and cutting (36.6%). Within noncontact cases, cutting (53.8%), pressing/tackling (50.2%), decelerating (38.9%), and landing (30.1%) were the most prevalent actions, whereas being tackled was most frequent in indirect contact cases (56.1%). For direct contact injuries, pooled action-specific estimates were available for being tackled (23.9%) and pressing/tackling (24.2%). Injuries typically occurred at high horizontal speed (53.8%; noncontact 70.7%), were more frequent during ball possession (67.5%) and offensive play (55.4%), and happened more early in time within the first 25% of the game in football (37.5%) and netball (37.8%). CONCLUSIONS: The identified patterns support the use of mechanism-specific, sport-tailored prevention strategies (e.g., technique/strength, neurocognitive functioning for noncontact, perturbation-based drills for indirect contact, and rules/choice of equipment for knee-directed contact). Methodological improvements, such as harmonized and more detailed injury reporting, are needed to refine risk estimates.