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ACL injury prevention

Jared J Murray, Colleen M Renier, Jenny J Ahern, Barbara A Elliott
OBJECTIVE: To document neuromuscular training (NMT) availability and its relationship to anterior cruciate ligament (ACL) injuries in 4 major high school sports by gender, sport, and rural/urban geography, with the hypothesis that increased exposure to NMT would be associated with fewer ACL injuries. DESIGN: A retrospective cohort study. SETTING: All Minnesota high schools identified in the Minnesota State High School League (MSHSL) database for fall 2014 boys' football and soccer, and girls' volleyball and soccer...
October 17, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Elizabeth Wellsandt, Ashutosh Khandha, Kurt Manal, Michael J Axe, Thomas S Buchanan, Lynn Snyder-Mackler
Anterior cruciate ligament (ACL) injury results in altered knee joint mechanics which frequently continue even after ACL reconstruction. The persistence of altered mechanical loading of the knee is of concern due to its likely role in the development of post-traumatic osteoarthritis (OA). Joint contact forces are associated with post-traumatic OA development, but evaluation of factors influencing the magnitude of contact forces after ACL injury is needed to advance current strategies aimed at preventing post-traumatic OA...
October 17, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Mohammad A Yabroudi, Haukur Björnsson, Andrew D Lynch, Bart Muller, Kristian Samuelsson, Majd Tarabichi, Jón Karlsson, Freddie H Fu, Christopher D Harner, James J Irrgang
BACKGROUND: Revision anterior cruciate ligament (ACL) reconstruction surgery occurs in 5% to 15% of individuals undergoing ACL reconstruction. Identifying predictors for revision ACL surgery is of essence in the pursuit of creating adequate prevention programs and to identify individuals at risk for reinjury and revision. PURPOSE: To determine predictors of revision ACL surgery after failed primary ACL reconstruction. STUDY DESIGN: Case-control study; Level of evidence, 3...
September 2016: Orthopaedic Journal of Sports Medicine
William T Wilson, Graeme P Hopper, Paul A Byrne, Gordon M MacKay
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction using tendon or ligament autograft is the gold standard surgical treatment for acute ruptures; however, this is still associated with subsequent problems and variable outcomes. Renewed interest in healing of injured ACL tissue has led to new surgical repair techniques. CASE DESCRIPTION: We report the case of one of the first patients to undergo this novel procedure of ACL repair with internal bracing. An internal brace is a bridging concept using braided suture tape and knotless bone anchors to reinforce ligament strength...
October 6, 2016: Surgical Technology International
Berardo Di Matteo, Markus Loibl, Luca Andriolo, Giuseppe Filardo, Johannes Zellner, Matthias Koch, Peter Angele
AIM: To systematically review the currently available literature concerning the application of biologic agents such as platelet-rich plasma (PRP) and stem cells to promote anterior cruciate ligament (ACL) healing. METHODS: A systematic review of the literature was performed on the use of biologic agents (i.e., PRP or stem cells) to favor ACL healing during reconstruction or repair. The following inclusion criteria for relevant articles were used: Clinical reports of any level of evidence, written in English language, on the use of PRP or stem cells during ACL reconstruction/repair...
September 18, 2016: World Journal of Orthopedics
Thomas R Coughlin, Oran D Kennedy
Osteoarthritis (OA), the most common musculoskeletal disease in the United States, is characterized by cartilage breakdown, pain, and restricted movement. Post-traumatic OA (PTOA) occurs subsequent to traumatic joint injury, such as anterior cruciate ligament (ACL) rupture, and makes up 12% of the overall disease burden, with healthcare costs of approximately $3 billion/year. The current paradigm for PTOA is based on the observation that joint injury affects multiple tissues, all of which may contribute to subsequent joint failure...
September 26, 2016: Annals of the New York Academy of Sciences
Radin Rafeeuddin, Raihana Sharir, Filip Staes, Bart Dingenen, Keith George, Mark A Robinson, Jos Vanrenterghem
The aim of this systematic review was (i) to identify neuromuscular markers that have been predictive of a primary non-contact ACL injury, (ii) to assess whether proposed risk factors have been supported or refuted in the literature from cohort and case-control studies, and (iii) to reflect on the body of research that aims at developing field based tools to assess risk through an association with these risk factors. Electronic searches were undertaken, of PubMed, SCOPUS, Web of Science, CINAHL and SPORTDiscus examining neuromuscular risk factors associated with ACL injury published between January 1990 and July 2015...
June 15, 2016: Physical Therapy in Sport
Timothy E Hewett, Gregory D Myer, Kevin R Ford, Mark V Paterno, Carmen E Quatman
Economic and societal pressures influence modern medical practice to develop and implement prevention strategies. Anterior cruciate ligament (ACL) injury devastates the knee joint leading to short term disability and long term sequelae. Due to the high risk of long term osteoarthritis in all treatment populations following ACL injury, prevention is the only effective intervention for this life-altering disruption in knee health. The 'Sequence of Prevention' Model provides a framework to monitor progress towards the ultimate goal of preventing ACL injuries...
September 9, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
May Arna Risberg, Hege Grindem, Britt Elin Øiestad
We like to think that we are successful in the treatment of individuals with anterior cruciate ligament (ACL) injury, but recent literature reveals that only about 60% of these individuals make a full recovery, less than 60% return to sport, and more than 50% develop knee osteoarthritis (OA) by middle age. Both short- and long-term outcomes after ACL injury and reconstruction need attention and action. We need to implement strategies early after ACL injury to prevent the development and progression of posttraumatic OA, rather than "sit and wait" until posttraumatic knee OA has developed...
September 2016: Journal of Orthopaedic and Sports Physical Therapy
Jessica C Martinez, Stephanie M Mazerolle, Craig R Denegar, Michael F Joseph, Kelly D Pagnotta, Thomas H Trojian, Lindsay J DiStefano
OBJECTIVES: To examine what factors influence a high school female athlete's stated willingness to perform a lower extremity injury prevention program (IPP). A secondary aim was to examine if a participant's stated willingness affected her compliance with an IPP. DESIGN: Repeated measures. METHODS: We surveyed high school female field hockey, soccer and volleyball athletes before and after a season-long IPP warm-up intervention. Participants completed the Injury Prevention Program Attitude Survey (IPPAS), a paper and pencil survey utilizing Likert-style and open-ended questions...
July 26, 2016: Journal of Science and Medicine in Sport
Matteo Guzzini, Daniele Mazza, Mattia Fabbri, Riccardo Lanzetti, Andrea Redler, Carlo Iorio, Edoardo Monaco, Andrea Ferretti
PURPOSE: The growing popularity of elite soccer among female participants has led to increased incidents of anterior cruciate ligament (ACL) ruptures. Many authors underline a positive glide after ACL reconstruction (ACLR), especially in women. In fact, an isolated intra-articular ACLR may be inadequate to control rotational instability after a combined injury of the ACL and the peripheral structures of the knee. Extra-articular procedures are sometimes used in primary cases displaying excessive antero-lateral rotatory instability...
October 2016: International Orthopaedics
Joseph L Yellin, Peter D Fabricant, Alex Gornitzky, Elliot M Greenberg, Sara Conrad, Julie Ann Dyke, Theodore J Ganley
BACKGROUND: Anterior cruciate ligament (ACL) tears are increasingly prevalent in the pediatric population. ACL rehabilitation is an essential component of recovery following injury and reconstruction, yet there are few explicit descriptions of pediatric-specific ACL rehabilitation protocols in the literature, especially in the context of varying treatment interventions. Our aim was to systematically review the literature on rehabilitation following ACL tears in children in order to describe common principles among different treatment options and areas of future research...
January 19, 2016: JBJS Rev
R John, M S Dhillon, K Syam, S Prabhakar, P Behera, H Singh
BACKGROUND: Sports-related knee injuries occur commonly in athletes. However, there is no published epidemiological study from India till date. OBJECTIVES: The purpose of this study was to identify common injuries sustained by Indian athletes participating in different sports and to study various associated demographic features. A secondary objective was to investigate different factors, which may affect return to sport by the athlete. STUDY DESIGN: Cross-sectional study (observational study)...
July 2016: Journal of Clinical Orthopaedics and Trauma
Olcay Guler, Mahir Mahırogulları, Serhat Mutlu, Mehmet H Cercı, Ali Seker, Selami Cakmak
INTRODUCTION: When treating anterior cruciate ligament (ACL) injuries, the position of the ACL graft plays a key role in regaining postoperative knee function and physiologic kinematics. In this study, we aimed to compare graft angle, graft position in tibial tunnel, and tibial and femoral tunnel positions in patients operated with anteromedial (AM) and transtibial (TT) methods to those of contralateral healthy knees. MATERIALS AND METHODS: Forty-eight patients who underwent arthroscopic ACL reconstruction with ipsilateral hamstring tendon autograft were included...
November 2016: Archives of Orthopaedic and Trauma Surgery
Anna Cronström, Mark W Creaby, Jenny Nae, Eva Ageberg
BACKGROUND: Increased knee abduction during weight-bearing activities is suggested to be a contributing factor for the high knee injury risk reported in women. However, studies investigating gender difference in knee abduction are inconclusive. OBJECTIVE: To systematically review gender-differences in knee abduction during weight-bearing activities in individuals with or without knee injury. METHODS: A systematic review and meta-analysis were conducted according to the PRISMA guidelines...
September 2016: Gait & Posture
P-M Xavier, J Fournier, B de Courtivron, F Bergerault, C Bonnard
INTRODUCTION: ACL enthesis tears are rare in children and there are very few reports in the literature. Characterized by avulsion of the ligament that tears off a very thin piece of cartilage or a bone fragment at the ACL epiphyseal insertion site, we hypothesize that conservative treatment by suture could reduce the number of patients requiring later ligament reconstruction. MATERIALS AND METHODS: Fourteen patients underwent surgery between 1986 and 2014 and were included in this retrospective study...
September 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Timothy E Hewett, Kevin R Ford, Yingying Y Xu, Jane Khoury, Gregory D Myer
BACKGROUND: The widespread use of anterior cruciate ligament (ACL) injury prevention interventions has not been effective in reducing the injury incidence among female athletes who participate in high-risk sports. PURPOSE/HYPOTHESIS: The purpose of this study was to determine if biomechanical and neuromuscular factors that contribute to the knee abduction moment (KAM), a predictor of future ACL injuries, could be used to characterize athletes by a distinct factor...
July 29, 2016: American Journal of Sports Medicine
Daniel C Herman, Jeffrey T Barth
BACKGROUND: Neurocognitive status may be a risk factor for anterior cruciate ligament (ACL) injury. Neurocognitive domains such as visual attention, processing speed/reaction time, and dual-tasking may influence ACL injury risk via alterations to neuromuscular performance during athletic tasks. However, the relationship between neurocognition and performance during athletic tasks is not yet established. HYPOTHESIS: Athletes with low baseline neurocognitive scores will demonstrate poorer jump landing performance compared with athletes with high baseline neurocognitive score...
September 2016: American Journal of Sports Medicine
Robert Eberle, Dieter Heinrich, Peter Kaps, Michael Oberguggenberger, Werner Nachbauer
A common anterior cruciate ligament (ACL) injury situation in alpine ski racing is landing back-weighted after a jump. Simulated back-weighted landing situations showed higher ACL-injury risk for increasing ski boot rear stiffness (SBRS) without considering muscles. It is well known that muscle forces affect ACL tensile forces during landing. The purpose of this study is to investigate the effect of different SBRS on the maximal ACL tensile forces during injury prone landings considering muscle forces by a two-dimensional musculoskeletal simulation model...
July 26, 2016: Journal of Sports Sciences
Mélanie L Beaulieu, Grace E Carey, Stephen H Schlecht, Edward M Wojtys, James A Ashton-Miller
BACKGROUND: Most ruptures of the native anterior cruciate ligament (ACL) and ACL graft occur at, or near, the femoral enthesis, with the posterolateral fibers of the native ligament being especially vulnerable during pivot landings. Characterizing the anatomy of the ACL femoral enthesis may help us explain injury patterns which, in turn, could help guide injury prevention efforts. It may also lead to improved anatomic reconstruction techniques given that the goal of such techniques is to replicate the knee's normal anatomy...
December 2016: Journal of Experimental Orthopaedics
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