Journal of Rafsanjan University of Medical Sciences
مجله دانشگاه علوم پزشکی رفسنجان
JRUMS
Medical Sciences
http://journal.rums.ac.ir
69
journal69
1735-3165
2008-7268
10.66224/jrums
fa
jalali
1405
3
1
gregorian
2026
6
1
25
3
online
1
fulltext
fa
تفاوتهای جنسیتی در بیومکانیک مفصل زانو و نیروهای عکسالعمل زمین پس از بازسازی رباط صلیبی قدامی حین راهرفتن: مرور نظاممند و متا-آنالیز
Gender Differences in the Knee Joint Biomechanics and Ground Reaction Forces after Anterior Cruciate Ligament Reconstruction during Gait: A Systematic Review and Meta-Analysis
توانبخشي و فيزيوتراپي
Rehabilitation
مقاله مروري
Review Article
<span style="font-size:10pt"><span style="line-height:114%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">چکیده</span></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:114%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">زمینه و هدف:</span></span></span></b> <span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">تفاوتهای جنسیتی خاص در بیومکانیک مفصل زانو و نیروهای عکسالعمل زمینی پس از جراحی بازسازی رباط صلیبی قدامی (</span></span></span>Anterior cruciate ligament reconstruction; ACLR<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">) حین راهرفتن مشخص شده است. بنابراین، نمیتوان مکانیک مفصل زانو و نیروهای عکسالعمل زمینی را در زنان همانند مردان فرض کرد. در این مرور نظاممند و متا-آنالیز، هدف مطالعه حاضر تعیین تفاوت جنسیت در بازیابی بیومکانیک مفصل زانو و نیروهای عکسالعمل زمینی پس از جراحی </span></span></span>ACLR<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> حین راهرفتن بود.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:114%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">مواد و روشها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> پنج پایگاه داده الکترونیکی شامل </span></span></span>Scopus<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">، </span></span></span>PubMed<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">، </span></span></span>EMBASE<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">، </span></span></span>PEDro<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> و </span></span></span>Cochrane Central Register of Controlled Trials<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> بهصورت نظاممند تا ژوئن 2026 برای شناسایی مقالات واجد شرایط بالقوه جستوجو شدند. نسخه اصلاح شده چکلیست </span></span></span>Downs<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> و </span></span></span>Black<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> برای ارزیابی کیفیت روششناختی مطالعات وارد شده بهکار گرفته شد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:114%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">یافتهها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> در نهایت شش مطالعه با میانگین کیفیت روش شناسی 66</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> درصد وارد مرور شدند. یافتههای مطالعات اصلی نشان دادهاند که در زیرگروه مرد، گشتاور اداکتوری زانو و نیروی عمودی عکسالعمل زمین در بیماران </span></span></span>ACLR<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> بهطور معنیداری، کمتر از گروه کنترل سالم یافت شد (05/0></span></span></span>P<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">). در زیرگروه زن، در بیماران </span></span></span>ACLR<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> نیروی عمودی عکسالعمل زمین بهطور معناداری بیشتر از گروه کنترل سالم مشاهده گردید (05/0></span></span></span>P<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">).</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:114%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">نتیجهگیری:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> یافتههای مرور نظاممند و متا-آنالیز حاضر بیانگر بازسازی متفاوت الگوی راهرفتن مردان در مقایسه با زنان با سابقه </span></span></span>ACLR<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> است. نتایج این مطالعه بر ضرورت طراحی برنامههای توانبخشی هدفمند بر اساس جنسیت برای اصلاح و تغییر الگوی بارگذاری مفصل زانو و نیروهای عکسالعمل زمینی پس از </span></span></span>ACLR<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> تأکید دارد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:114%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">واژههای کلیدی:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""> جراحی </span></span></span>ACL<span lang="FA" style="font-size:12.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">، زاویه مفصل، گام برداری</span></span></span></span></span></span></span></span><br>
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" style="position:absolute; left:0; text-align:left; margin-left:22px; margin-top:2px; width:467.05pt; height:45pt; z-index:-251648512; v-text-anchor:top"> <w:wrap anchorx="margin"> </w:wrap></v:roundrect><b><span lang="FA" style="font-size:3.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin""></span></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:114%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">ارجاع:</span></span></span></b> <span lang="FA" style="font-size:11.0pt"><span style="line-height:114%"><span style="font-family:"B Nazanin"">اسماعیلی ع، جعفرنژادگرو اع، رضازاده ف، نکته سنج ر. تفاوتهای جنسیتی در بیومکانیک مفصل زانو و نیروهای عکسالعمل زمین پس از بازسازی رباط صلیبی قدامی حین راهرفتن: مرور نظاممند و متا-آنالیز . سال 1405، دوره 25، شماره 3، صفحات: 318-299.</span></span></span></span></span></span></span></span><br>
<span style="line-height:115%"><a name="_Hlk114425361"><b><span style="line-height:115%">Background and Objectives:</span></b></a> <span style="line-height:115%">Specific gender differences in knee joint biomechanics and ground reaction forces after anterior cruciate ligament reconstruction (ACLR) surgery during gait have been identified. Therefore, it is not possible to assume the knee joint mechanics and ground reaction forces in males as well as females. In this systematic review and meta-analysis, we aimed to investigate gender differences in the restoration of knee joint biomechanics and ground reaction forces after anterior cruciate ligament reconstruction during gait.</span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Materials and Methods:</span></b><span style="line-height:115%"> Five electronic databases including Scopus, PubMed, EMBASE, PEDro, and Cochrane Central Register of Controlled Trials were systematically searched for articles potentially eligible for inclusion until June 2026. The modified version of the Downs and Black checklist was used to assess the methodological quality of the included studies.</span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Results:</span></b><span style="line-height:115%"> Ultimately, six studies with a mean methodological quality of 66% were included in the review. The findings of the main studies showed that in the male subgroup, knee adduction torque and vertical ground reaction force in ACLR patients were significantly lower than in the healthy control group (p<0.05). In the female subgroup, vertical ground reaction force in ACLR patients was significantly higher than in the healthy control group (p<0.05).</span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Conclusion: </span></b><span style="line-height:115%">The findings of the present systematic review and meta-analysis indicate a differential reconstruction of gait pattern in men compared to women with a history of ACLR. The results of this study emphasize the necessity of designing sex-specific targeted rehabilitation programs to correct knee joint movement limitations and alter knee joint loading patterns and ground reaction forces following ACLR.</span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Keywords:</span></b><span style="line-height:115%"> ACL surgery, Joint Angle, Gait</span></span><br>
<span style="line-height:115%"><span style="line-height:115%"></span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Funding:</span></b><span style="line-height:115%"> This study did not receive any funds. </span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Conflict of interest:</span></b><span style="line-height:115%"> None declared.</span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Ethical considerations:</span></b><span style="line-height:115%"> Not applicable.</span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">Authors’ contributions:</span></b></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">- Conceptualization: </span></b><span style="line-height:115%">Ali Esmaeili, Amirali Jafarnezhadgero<b> </b></span></span><br>
<span style="line-height:115%"><b><span style="line-height:115%">- Methodology: </span></b><span style="line-height:115%">Ali Esmaeili, Amirali Jafarnezhadgero, Farhad Rezazadeh</span></span><br>
<span style="line-height:115%"><b><span lang="PT-BR" style="line-height:115%">- Data collection: </span></b><span lang="PT-BR" style="line-height:115%">Ali Esmaeili, Amirali Jafarnezhadgero</span></span><br>
<span style="line-height:115%"><b><span lang="PT-BR" style="line-height:115%">- Formal analysis: </span></b><span lang="PT-BR" style="line-height:115%">Ali Esmaeili, Amirali Jafarnezhadgero</span></span><br>
<span style="line-height:115%"><b><span lang="PT-BR" style="line-height:115%">- Supervision: </span></b><span lang="PT-BR" style="line-height:115%">Ali Esmaeili, Amirali Jafarnezhadgero</span></span><br>
<span style="line-height:115%"><b><span lang="PT-BR" style="line-height:115%">- Project administration: </span></b><span lang="PT-BR" style="line-height:115%">Ali Esmaeili, Amirali Jafarnezhadgero</span></span><br>
<span style="line-height:115%"><b><span lang="PT-BR" style="line-height:115%">- Writing – original draft:</span></b><span lang="PT-BR" style="line-height:115%"> Ali Esmaeili</span></span><br>
<span style="line-height:115%"><b><span lang="PT-BR" style="line-height:115%">- Writing – review & editing: </span></b><span lang="PT-BR" style="line-height:115%">Ali Esmaeili, Amirali Jafarnezhadgero, Farhad Rezazadeh, Reza Noktehsanj</span></span><br>
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<div><span style="font-size:10pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:150%">Citation: </span></span></b><span style="font-size:9.0pt"><span style="line-height:150%">Esmaeili A, Jafarnezhadgero AA, Rezazadeh F, Noktehsanj R. Gender Differences in the Knee Joint Biomechanics and Ground Reaction Forces after Anterior Cruciate Ligament Reconstruction during Gait: A Systematic Review and Meta-Analysis.<b> </b><i>J Rafsanjan</i> <i>Univ Med Sci</i> 2026; 25 (3): 299-318. </span></span><span style="font-size:9.0pt"><span style="line-height:150%">doi: 10.66224/jrums.25.3.299. </span></span><span style="font-size:9.0pt"><span style="line-height:150%">[Farsi] </span></span></span></span></span></div>
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<span style="font-size:11pt"><span style="line-height:115%"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span style="font-size:12.0pt"><span style="line-height:115%"></span></span></span></span></span></span>
جراحی ACL, زاویه مفصل, گام برداری
ACL surgery, Joint Angle, Gait
299
318
http://journal.rums.ac.ir/browse.php?a_code=A-10-3488-31&slc_lang=fa&sid=1
Ali
Esmaeili
علی
اسماعیلی
alismaeelisky76@gmail.com
6900319475328460063754
6900319475328460063754
No
University of Mohaghegh Ardabili
دانشگاه محقق اردبیلی
Amir Ali
Jafarnezhadgero
امیرعلی
جعفرنژادگرو
amiralijafarnezhad@gmail.com
6900319475328460063755
6900319475328460063755
Yes
University of Mohaghegh Ardabili
دانشگاه محقق اردبیلی
Farhad
Rezazadeh
فرهاد
رضازاده
rezazadeh.farhad@uma.ac.ir
6900319475328460063756
0009-0003-4190-935X
No
University of Mohaghegh Ardabili
دانشگاه محقق اردبیلی
Reza
Noktehsanj
رضا
نکته سنج
rezanoktehsanj@gmail.com
6900319475328460063757
6900319475328460063757
No
Ardabil University of Medical Sciences
دانشگاه علوم پزشکی اردبیل