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Objective To study the effect of gender and maneuvers on anterior cruciate ligament (ACL) injury risk factors for volleyball players. Methods Sports biomechanics data of volleyball players during stop-jump, drop landing and sidestep cutting were collected. The ACL injury rate and biomechanical parameters of simulated injured jumps were obtained with Monte Carlo simulation. The influence of gender and maneuvers on ACL injury risk factors was validated by 2×3 mixed designed two-way ANOVA. Results Sidestep cutting was the highest risk maneuver of ACL injury for both genders (P＜0.001). Compared with male players, female players had a greater risk of ACL injury during sidestep cutting and stop-jump (P＜0.001), while male players were more prone to have ACL injury than female players during drop landing (P＜0.001). The risk factors of ACL injury obtained by simulation were significantly influenced by gender and maneuvers (P＜0.001). Conclusions Male players were more likely to increase ACL load due to smaller knee flexion, forward leg tilt and heel landing than female players during sidestep cutting, while female players owned larger ground reaction force (GRF) and knee extension moment. Smaller knee flexion angle during stop jump was the major risk factor for both genders, however more characteristics contributed to the males. Female players with large GRF, knee valgus and extension moment, and heel-landing were likely to have ACL injury, while the small knee flexion angle was the key risk factor for male players. The results can provide evidences for evaluation of volleyball players’ ACL injury risk, individualized injury prevention protocols, and clinical treatment and rehabilitation directions.
RESUMO
<p><b>OBJECTIVE</b>To investigate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on the stability of resin-dentin bonds against pH cycling.</p><p><b>METHODS</b>Resin-bonded dentin specimens were prepared following manufacturers' instructions, and randomly divided into 3 groups. Among them, 2 groups experienced pH cycling, in which specimens applied CPP-ACP or distilled and deionized water (DDW) on the bonding interface, respectively. Microtensile bond strength (muTBS) testing, failure mode analysis, micromorphological and nanoleakage evaluation of bonding interface and elemental analysis within hybrid layer were performed after 15 days pH cycling. The other group was tested immediately after specimens' preparation without pH cycling.</p><p><b>RESULTS</b>No significant differences were found in muTBS between no pH cycling and pH cycling/CPP-ACP group. Their muTBS were both significantly higher than that of pH cycling/DDW group (P < 0.05). Mixed fractures were the most prevalent failure mode. The quality of hybrid layer in pH cycling/CPP-ACP group was better than that of pH cycling/DDW group, and the nanoleakage was also less severe. Comparing with pH cycling/DDW group, the atomic percentages of Ca in the other two groups were both significantly higher, while those of Ag were statistically lower (P < 0.05).</p><p><b>CONCLUSION</b>Local application of CPP-ACP can promote the stability of resin-dentin bonding interface against pH cycling and prolong bonding degeneration.</p>