نوع مقاله : مقاله مروری
نویسندگان
1 دانشکده تربیت بدنی و علوم ورزشی ،دانشگاه تهران،تهران،ایران
2 دانشیار، گروه حرکات اصلاحی و آسیب شناسی ورزشی، دانشکده تربیت بدنی، دانشگاه تهران، تهران، ایران
3 استاد، گروه حرکات اصلاحی و آسیب شناسی ورزشی، دانشکده تربیت بدنی، دانشگاه تهران، تهران، ایران
چکیده
کلیدواژهها
موضوعات
عنوان مقاله [English]
نویسندگان [English]
Background and Aims: Non-contact anterior cruciate ligament (ACL) injuries are among the most common and debilitating knee injuries in sports, often resulting in prolonged rehabilitation, increased risk of reinjury, functional limitations, and reduced performance. Hip rotational range of motion (ROM), including internal rotation and external rotation, plays a key role in controlling lower-limb alignment and may influence knee valgus and rotational loads associated with ACL injury mechanisms. However, evidence regarding the association between hip rotation ROM and non-contact ACL injury is conflicting. This systematic review and meta-analysis aimed to investigate whether hip internal rotation and external rotation ROM differ between individuals with non-contact ACL injury and healthy subjects.
Methods: This study followed PRISMA 2020 guidelines. Comprehensive searches were conducted in PubMed, Scopus, Web of Science, ProQuest, ScienceDirect, SID, and Magiran from inception to November 2025. Observational studies assessing hip internal rotation or external rotation ROM in individuals with confirmed non-contact ACL injury and healthy controls were included. Data extraction and quality assessment were performed independently by two reviewers using the modified Downs and Black checklist. Standardized mean differences (SMD) were pooled using a random-effects model. Heterogeneity was assessed using I² and Cochran’s Q. Publication bias was evaluated through funnel plots and Egger’s regression tests. Sensitivity analysis was performed using the leave-one-out method.
Results: Fourteen studies (1437 participants) were eligible for the internal rotation analysis and 13 studies (1113 participants) for the external rotation analysis. Meta-analysis showed no significant differences between the ACL-injured and control groups for hip internal rotation (SMD = –0.60; 95% CI: –1.40 to 0.20; p = 0.14; I² = 0%) or hip external rotation (SMD = –0.45; 95% CI: –1.23 to 0.33; p = 0.26; I² = 0%). Negative SMDs indicate lower ROM in the ACL-injured group. Sensitivity analyses confirmed the stability of the findings. Egger’s test detected no publication bias for either variable (internal rotation: p = 0.69; external rotation: p = 0.95).
Conclusion: It seems that hip internal rotation and external rotation ROM alone are not to be independent predictors of non-contact ACL injury. However, combined rotational imbalance, particularly increased internal rotation with limited external rotation, may contribute to altered knee loading patterns in high-risk individuals. Multidimensional biomechanical assessment, rather than reliance on isolated hip ROM measures, is recommended for ACL injury screening and prevention.
کلیدواژهها [English]
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