确定前交叉韧带损伤概率及危险因素的随机生物力学模型与模拟

    Stochastic Biomechanical Model and Simulation for the Injury Rate and Risk Factors of the Non-contact ACL Injury

    • 摘要: 确定损伤风险因素是有效预防非接触性前交叉韧带损伤的关键。目的:建立前交叉韧带损伤随机生物力学模型, 确定与损伤率有因果关系的风险因素。方法:在前交叉韧带负荷的生物力学模型基础上建立前交叉韧带损伤的随机生物力学模型, 采用蒙特卡洛模拟方法预测急停起跳落地动作时前交叉韧带损伤概率, 并判断影响损伤概率的风险因素。随机模型所需要的各独立变量的分布来自于19名男性和18名女性运动员的实测数据。结果:女性损伤概率是男性的4.91±0.25倍。模拟的损伤组比非损伤组的膝屈角更小、向后地面反力峰值更大。结论:模型预测的男、女损伤概率比、损伤膝角均与文献研究结果一致, 证明了模型预测前交叉韧带负荷的有效性。着地瞬间的向后地面反作用力第一峰值和膝关节屈角是ACL损伤的风险因素。

       

      Abstract: It is important to understand the biomechanical risk factors of the non-contact ACL injury to develop effective prevention programs.The purpose of this study was to validate a stochastic biomechanical model for non-contact ACL injuries, which can determine the causeand-effect relationship and risk factors.Methods:A stochastic biomechanical model for noncontact ACL injuries was developed and instrumented to a Monte Carlo simulation to estimate the ACL injury rate and risk factors during landing of the stop-jump task.The distributions of independent variables were determined from vivo data of 19 male and 18 female athletes.Results:The female-to-male non-contact ACL injury rate ratio was 4.91±0.25.In the simulated injured trials, there are smaller knee flexion angle, greater posterior GRF, and greater proximal tibia anterior shear force in comparison to the simulated uninjured trials.Conclusion:The estimated female-to-male non-contact ACL injury rate ratio and knee flexion angle for the injury were similar to that reported in the literature, which supports the overall validity of the model for estimating ACL loading.1st peak posterior ground reaction force and knee flexion angle are two important risk factors of non-contact ACL injury.

       

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