ACL Injuries and Treatment

Volleyball players often land on a single leg following a spike shot due to a shift in the center of gravity and loss of balance. Landing on a single leg following a spike may increase the probability of non-contact anterior cruciate ligament (ACL) injuries. The purpose of this study was to compare and analyze the kinematics and kinetics differences during the landing phase of volleyball players using a single leg (SL) and double-leg landing (DL) following a spike shot. The data for vertical ground reaction forces (VGRF) and sagittal plane were collected. SPM analysis revealed that SL depicted a smaller knee flexion angle (about 13.8°) and hip flexion angle (about 10.8°) during the whole landing phase, a greater knee and hip power during the 16.83–20.45% (p = 0.006) and 13.01–16.26% (p = 0.008) landing phase, a greater ankle plantarflexion angle and moment during the 0–41.07% (p < 0.001) and 2.76–79.45% (p < 0.001) landing phase, a greater VGRF during the 5.87–8.25% (p = 0.029), 19.75–24.14% (p = 0.003) landing phase when compared to DL. Most of these differences fall within the time range of ACL injury (30–50 milliseconds after landing). To reduce non-contact ACL injuries, a landing strategy of consciously increasing the hip and knee flexion, and plantarflexion of the ankle should be considered by volleyball players.

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Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211005090 ◽

2021 ◽

Vol 9 (4) ◽

pp. 232596712110050

Author(s):

Hanna Tigerstrand Grevnerts ◽

Sofi Sonesson ◽

Håkan Gauffin ◽

Clare L. Ardern ◽

Anders Stålman ◽

...

Keyword(s):

Decision Making ◽

High Activity ◽

Treatment Decision ◽

Acl Injury ◽

Treatment Decisions ◽

Activity Level ◽

Knee Instability ◽

Acl Injuries ◽

Patient Reported ◽

And Function

Background: In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. Purpose: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate. Results: The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older ( P = .031) and had a lower preinjury activity level than did those in the acute-phase ( P < .01) and subacute-phase ( P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury. Conclusion: Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management. Registration: NCT02931084 ( ClinicalTrials.gov identifier).

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ACL Injuries: More to Learn

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2007.0101 ◽

2007 ◽

Vol 37 (2) ◽

pp. 32-32

Author(s):

Guy G. Simoneau

Keyword(s):

Acl Injuries

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Experiences of returning to elite alpine skiing after ACL injury and ACL reconstruction

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2012-0114 ◽

2014 ◽

Vol 26 (1) ◽

pp. 69-77 ◽

Cited By ~ 7

Author(s):

Birgitta Nordahl ◽

Rita Sjöström ◽

Maria Westin ◽

Suzanne Werner ◽

Marie Alricsson

Keyword(s):

High School Students ◽

Cruciate Ligament ◽

Acl Injury ◽

Alpine Skiing ◽

Structured Interviews ◽

School Students ◽

Physical Ability ◽

Acl Injuries ◽

Elite Level ◽

Passive Strategies

Abstract Aim: To explore the experiences of alpine skiing at the elite level after anterior cruciate ligament (ACL) injury and reconstruction. Design: A qualitative approach where semi-structured interviews were conducted, and an analysis of the manifest content was performed. Participants: Five ski high school students, two male and three female skiers, who had suffered ACL injuries and undergone ACL reconstructions. Results: Seven categories were identified. The participants described their perceived opportunities with regard to returning to alpine skiing after ACL injury and reconstruction as something positive to do with self-belief, being mentally and physically prepared, regaining confidence in their own ability, being given time and using active strategies. In contrast, perceived barriers to a return to elite alpine skiing gave rise to negative feelings, for example, fear, disheartenment, a total lack of or ambivalent confidence in their own ability and the use of passive strategies. Conclusion: The two male skiers returned to alpine skiing. They reported confidence in their own ability, active strategies and support on all levels, as well as enhanced physical ability. The female skiers did not return to their pre-injury level of competitive alpine skiing. They stated a lack of support on all levels, deterioration in their physical ability and two out of three reported passive strategies and no or ambivalent confidence in their own ability. The most important factors were family support, support on all levels, access to a physiotherapist and time given.

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