scholarly journals Feedback cues improve the alignment and technique of children performing ACL injury prevention exercises

2020 ◽  
pp. jisakos-2020-000475
Author(s):  
Daphne I Ling ◽  
Caroline Boyle ◽  
Joseph Janosky ◽  
Brenda Chang ◽  
Naomi Roselaar ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Case Series ◽  
Ligament Injury ◽  
Neuromuscular Training ◽  
Level Of Evidence ◽  
Training Exercises ◽  
Neutral Alignment ◽  
Feedback Cues

ObjectivesThe appropriateness of neuromuscular training exercises across different age groups has not yet been investigated, particularly in younger children. The purpose of this study was to determine which neuromuscular training exercises can be performed with proper neutral alignment in various age groups.MethodsSeven exercises were selected for evaluation in children ranging from 8 to 17 years of age who were recruited from schools and youth sports organisations. Participants completed two trials of each exercise and were judged on maintaining neutral body alignment after receiving visual/verbal instruction on the first trial and feedback cues on the second trial. Three evaluators judged each exercise, which was deemed as correct when at least two evaluators agreed that neutral alignment was maintained. Comparisons were made across ages and between sex using the χ² test or Fisher’s exact test. The proportions of participants who performed the exercise correctly were also compared before and after feedback cues were provided.ResultsA total of 360 participants were evaluated (8–11 years: 165, 54% female; 12–15 years: 136, 40% female, 16–17 years: 59, 53% female). There were no significant differences in performance across ages and sex for nearly all exercises. The majority of children were not able to complete the exercises with proper alignment. The use of feedback cues significantly increased the proportion of participants who correctly completed the exercise (p<0.001).ConclusionsThese results demonstrate the importance of training coaches and physical education teachers to provide cues that reinforce proper technique during anterior cruciate ligament injury prevention exercises. Children should perform common neuromuscular training exercises with feedback on proper technique.Level of evidenceIV (case series).

scholarly journals Confirming Proper Button Deployment of Suspensory Fixation During ACL Reconstruction

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097434
Author(s):  
Daniel F. O’Brien ◽  
Lilah Fones ◽  
Victoria Stoj ◽  
Cory Edgar ◽  
Katherine Coyner ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Acl Reconstruction ◽  
Sports Medicine ◽  
Cruciate Ligament ◽  
Case Series ◽  
Graft Fixation ◽  
Level Of Evidence ◽  
Lateral Cortex ◽  
Suture Button ◽  
Suspensory Fixation

Background: Suspensory fixation of anterior cruciate ligament (ACL) reconstruction (ACLR) grafts has emerged as a popular device for femoral graft fixation. However, improper deployment of the suspensory fixation can compromise proper graft tensioning, leading to failure and revision. Also, soft tissue interposition between the button and bone has been associated with graft migration and pain, occasionally requiring revision surgery. Many surgeons rely on manual testing and application of distal tension to the graft to confirm proper button deployment on the lateral cortex of the femur for ACL graft fixation. Purpose: To determine the reliability of the manual resistance maneuver when applying distal tension to deploy the suspensory device along the lateral cortex of the femur. Study Design: Case series; Level of evidence, 4. Methods: All patients undergoing ACLR with a suture button suspensory device for femoral fixation were eligible for enrollment in the study. The surgeries were performed by 3 board-certified, sports medicine fellowship–trained orthopaedic surgeons at a single outpatient surgical center between May 2018 and June 2019. All grafts were passed in a retrograde manner into the femoral tunnel, and a vigorous manual tensioning maneuver in a distal direction was placed on the graft to deploy and secure along the lateral cortex of the femur. Intraoperative mini c-arm fluoroscopy was obtained to demonstrate proper suture button positioning. If interposing tissue or an improperly flipped button was identified, rectifying steps were undertaken and recorded. Results: A total of 51 patients with a mean age of 33.3 years were included in the study. Of these patients, 74.5% had normal suture button positioning identified via intraoperative fluoroscopic imaging, while 15.7% had interposed soft tissue and 9.8% had an improperly flipped button. In all cases, the surgeon was able to rectify the malpositioning intraoperatively. Conclusion: Despite the manual sensation of proper suspensory button positioning, intraoperative fluoroscopy identified suture button deployment errors in ACLR 25% of the time. Correcting the malpositioning is not technically demanding. These findings advocate for routine intraoperative surveillance to confirm appropriate suture button seating during ACLR.

scholarly journals Landing Error Scoring System for Screening Risk Scores among Elite-Youth Soccer Players

2021 ◽  
Vol 7 (1) ◽  
pp. 351
Author(s):  
Yasar Salci
Keyword(s):  
Scoring System ◽  
Cruciate Ligament ◽  
Screening Method ◽  
Age Groups ◽  
Neuromuscular Control ◽  
Soccer Players ◽  
Risk Scores ◽  
Ligament Injury ◽  
Youth Soccer ◽  
Anterior Cruciate

Identifying the risk of anterior cruciate ligament injury is very important for the careers of elite players. When identifying risk factors, effective, easy, valid, reliable methods applicable to a large number of participants should be used. The purpose of this study was to compare the landing pattern of elite-youth soccer players using the landing error scoring system (LESS) which is a valid and reliable qualitative screening method. 95 volunteer elite-youth soccer players (U19, U17, U16 & U15) between the ages of 14 and 18 participated in this study. Jump-landings were recorded by two camcorders from sagittal and frontal planes. These records were replayed and scored by a trained rater on LESS score sheets. There were statistically significant differences in LESS scores among the soccer age groups (p = 0.00). Post-hoc analysis demonstrated significant differences between U19 and U17 (p = 0.00), U17 and U15 (p = 0.00) and U16 and U15 (p = 0.01) soccer players. The best LESS score was found in U17 players and U15 players had the weakest score. The higher LESS score of the U15 players may be related to the neuromuscular control ability however, more evidence is needed to confirm the potential influence of age categories on LESS scores.

Prevalence of anterior cruciate ligament injury among amateur footballers in Enugu, South-East Nigeria: The need for injury prevention programs

2020 ◽  
Vol 29 (3) ◽  
pp. 422
Author(s):  
UgochukwuUzodimma Nnadozie ◽  
ChristianChibuzor Ndubuisi ◽  
EmelieMoris Anekwu ◽  
CharlesChidiebele Maduba ◽  
HenryChinedum Ekwedigwe ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Prevention ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Prevention Programs ◽  
Ligament Injury ◽  
Anterior Cruciate

scholarly journals Scaphoid Fractures below the Age of 10: Case Series and Review of the Literature

2020 ◽  
Vol 9 (06) ◽  
pp. 458-464
Author(s):  
Rachana Tataria ◽  
Jeannette Ting ◽  
Andrea Jester ◽  
Tommy R. Lindau ◽  
Kerstin Oestreich
Keyword(s):  
Pediatric Population ◽  
Age Groups ◽  
Case Series ◽  
Final Diagnosis ◽  
Scaphoid Bone ◽  
Age Group ◽  
Level Of Evidence ◽  
Scaphoid Fractures ◽  
Fractures In Children ◽  
Common Location

Abstract Background Scaphoid fractures are relatively uncommon in children, especially below the age of 10 due to the ossification of the scaphoid bone, which starts around 4 to 6 years of age and continues until 13 to 15 years of age, where pediatric scaphoid fractures peak. This makes the diagnoses challenging in this age group. Methods The primary aim of this study was to analyze prospectively collected data in managing scaphoid fractures. All cases in children up to the age of 10 years, treated in a tertiary pediatric hand and upper limb from January 2014 to June 2018 were included. Parameters studied were patient demographics, clinical presentation, mechanism of injury, investigations, type of fracture, associated injuries, treatment offered, outcomes and complications. The secondary aim was to review the literature due to the limited knowledge about these fractures in these low age groups. Results A total of 23 patients with documented scaphoid fractures in children up to the age of 10 years were found. Final diagnosis in all these patients was done with magnetic resonance imaging (MRI). The mean age was 9.8 years, with female preponderance. Scaphoid waist was the most common location. Five patients had associated fractures of the capitate and one patient had associated second metacarpal base fracture. All patients were managed nonoperatively. The average time of immobilization was 6.6 weeks (range: 4–10 weeks). A majority of patients had minor symptoms after the fracture, most likely due to the immobilization time. Conclusion Scaphoid fractures are rare in the pediatric population up to the age of 10. MRI is most often needed to confirm diagnosis. Nonoperative management of most scaphoid fractures in this age group is safe and feasible with no significant long-term morbidity. Surgical management of scaphoid fractures might be required in very selected cases. Level of Evidence This is a Level IV study.

scholarly journals Combined Intra- and Extra-Articular Technique in Revision Anterior Cruciate Ligament Reconstruction

Joints ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 156-163 ◽  
Author(s):  
Jessica Zanovello ◽  
Federica Rosso ◽  
Alessandro Bistolfi ◽  
Roberto Rossi ◽  
Filippo Castoldi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Return To Sport ◽  
Surgical Removal ◽  
Level Of Evidence ◽  
Anterior Cruciate ◽  
Over The Top

Purpose The aim of the study was to evaluate the “over the top” (OTT) nonanatomical technique for revision of anterior cruciate ligament (ACL) reconstruction. Methods Twenty-four patients with a mean age of 31.9 ± 11.2 years underwent revision of ACL reconstruction using OTT technique. International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, Tegner score, Subjective Patient Outcome for Return to Sport (SPORTS) score, Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale, and KT-1000 evaluation were recorded at a mean follow-up of 30.7 ± 18.9 months. Results Postoperatively, the IKDC objective total score significantly improved (p = 0.0046). The KOOS, Lysholm, and Tegner scores also improved, but the results were not statistically significant (62.4 vs. 72.6, 6.5 vs. 75.8, and 4.1 vs. 6.0, respectively). The subjective IKDC evaluation score improved from an average of 51.1 points to 63.7 points at the last follow-up (p = 0.0027). The RTP prevalence was 81.8%, with 44.4% of the patients returning to the same preinjury level. According to the SPORTS score, 16.6% of patients played sport without limitations in activity and performance. The average ACL-RSI score was 52.1 ± 27.0. No major complications were reported. A total of 21.5% of patients underwent surgical removal of staples. The failure prevalence was 14.3% and the cumulative survivorship, calculated using the Kaplan–Meier method, was equal to 70% at 60 months of follow-up. Conclusion The OTT technique in the revision ACL reconstruction provided improvement in objective and subjective scores, good RTP prevalence, and acceptable rate of complication and failure. One of the advantages was the possibility to avoid the femoral tunnel. Level of Evidence Level IV, therapeutic case series.

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