前交叉韧带损伤的风险因素研究进展

Research progress on the risk factors for anterior cruciate ligament injury

前交叉韧带（anterior cruciate ligament，ACL）对于保持膝关节静态和动态稳定性非常重要。在运动中前交叉韧带通常因为膝外展和外翻位跳落、突然加速、变向、旋转等非接触机制造成损伤。可控风险因素和非可控风险因素使运动员处于前交叉韧带损伤高风险状态。前交叉韧带损伤后造成患者疼痛、膝关节不稳定、继发性膝关节损害、活动障碍等不良后果。因此，前交叉韧带损伤的风险因素研究逐渐增多。通过干预措施减少易感人群在运动活动中的可控风险因素来预防前交叉韧带损伤是治疗前交叉韧带损伤的重要研究方向。

With the extensive development of competitive sports, especially soccer, etc, the incidence of anterior cruciate ligament （ACL） injury shows an increasing trend. The ACL injury causes associated consequences such as knee recurrent injury, pain, limitation of motion, knee instability, secondary osteoarthritis and so on. Therefore, the research on the risk factors of ACL injury has becoming the hotspot gradually. Multiple risk factors contribute to ACL injury, including uncontrollable risk factors such as anatomical risk factors, genetic risk factors, etc, and controllable risk factors such as environmental risk factors, hormonal risk factors, neuromuscular risk factors, biomechanical risk factors, etc. The recent literature is reviewed. The potential intervention capability of preventing non-contact ACL injury through modification of uncontrollable risk factors such as anatomical risk factors, genetic risk factors, etc, is limited. And therefore, when researching on risk factors for ACL injury, the controllable risk factors such as hormonal risk factors, neuromuscular risk factors, biomechanical risk factors, etc, are mainly focused, through making the mechanism of action of ACL injury caused by controllable risk factors clear, so as to explore the preventive measures, and further to reduce the risk. There are broad prospects and practical value for the study of hormonal factors and biomechanical factors, and such research will be the focus in the next step. At present, the research on the controllable risk factors is mostly done by foreign professors, and is rarely done in China, where the anatomical risk factors are mainly focused. Currently, that all the risk factors are interrelated is the difficulty and limitation for the research on multiple risk factors for ACL injury. Because it is difficult to control other confounding risk factors when a single risk factor is being studied, the research results are not convincing. In conclusion, the comprehensive study on the multiple risk factors will be the future research area, and further to evaluate the risk of ACL injury.