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AJSM：女性青春期不同发育阶段对膝关节前交叉韧带的（ACL）负荷的影响

2021-10-28 MedSci原创 MedSci原创

性别差异前交叉韧带（ACL）负荷
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青春期晚期的女性体重更高，需要更高的肌肉力量来支撑活动的身体，这可能会增加ACL负荷。

前交叉韧带（ACL）断裂是一种常见的膝关节损伤，会增加早发性膝关节骨性关节炎的风险以及产生巨额的医疗费用（即手术护理和物理治疗）。过去二十年来，年轻人ACL断裂的发生率急剧上升，由此产生的早发性膝关节骨性关节炎的负担会落在有ACL损伤史的年轻人身上。

临床研究已观察到ACL断裂率和性别、年龄有关。与男性运动员相比，女性运动员发生ACL损伤的风险要高2至4倍。与青春期前女孩相比，青春期晚期至后期女性，尤其是15至19岁的女性有更大的ACL损伤风险。然而，年轻女性ACL损伤风险增加的确切因果机制尚未被提出。为了探究这个机制，研究人员选取了19名青春期前、19名青春期早期和24名青春期晚期女性，用标准化落地侧跳来获得三维身体运动、地面反作用力和肌电图数据。

(A)以优势腿站立于盒子中央，双手交叉于胸前;(B)从盒子上跳下，以优势腿落在距离盒子中心10厘米的一个标记目标上;(C)向90度方向侧向跳跃，对侧腿在150%的腿长距离着地。

研究数据发现，与青春期前和青春期早期/中期女性相比，青春期晚期/后期女性的前交叉韧带力显著较高，在前30%和48%至85%的站姿期间平均差异为471 N和356 N，在前24%和59%至81%的站姿期间平均差异为343 N和274 N，与前交叉韧带力峰值重叠。在ACL力峰值点，与青春期前和青春期早期/中期组相比，青春期后矢状面和横面加载机制对ACL力的贡献更大。青春期前组和青春期早期/中期组之间的ACL力及其影响因素没有差异。简单来说，在青春期晚期的女性中能够观察到最高的ACL力量，这与最近报道的15-19岁女性ACL损伤率的上升相一致。

 

每个青春期组的ACL力图

因此，本研究认为在青春期成熟前，10岁左右ACL体积的增长趋于平稳。然而，青春期晚期的女性体重更高，需要更高的肌肉力量来支撑活动的身体，这可能会增加ACL负荷。因此，如果这些女性产生更大力量的部分原因是她们的体重较高，且这部分力量将应用于ACL，导致ACL并不成比例地增大。这可能部分解释了青春期晚期女性ACL损伤率较高的原因。

参考文献：.Azadeh Nasseri, et al. Effects of Pubertal Maturation on ACL Forces During a Landing Task in Females.The American Journal of Sports Medicine 2021;49(12):3322–3334.DOI:10.1177/03635465211038332

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    2021-10-30 zhzhxiang

    #青春期#

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    2021-10-30 neurowu

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    2021-10-30 smartjoy

    #前交叉韧带#

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    2021-10-30 juliusluan81

    #韧带#

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