Video Analysis of Anterior Cruciate Ligament Tears in Professional American Football Athletes

2018 ◽  
Vol 46 (4) ◽  
pp. 862-868 ◽  
Author(s):  
Jeffrey T. Johnston ◽  
Bert R. Mandelbaum ◽  
David Schub ◽  
Scott A. Rodeo ◽  
Matthew J. Matava ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Video Analysis ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Case Series ◽  
American Football ◽  
Football Players ◽  
Acl Injuries ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injuries are prevalent in contact sports that feature cutting and pivoting, such as American football. These injuries typically require surgical treatment, can result in significant missed time from competition, and may have deleterious long-term effects on an athlete’s playing career and health. While the majority of ACL tears in other sports have been shown to occur from a noncontact mechanism, it stands to reason that a significant number of ACL tears in American football would occur after contact, given the nature of the sport. Hypothesis/Purpose: The purpose was to describe the mechanism, playing situation, and lower extremity limb position associated with ACL injuries in professional American football players through video analysis to test the hypothesis that a majority of injuries occur via a contact mechanism. Study Design: Case series; Level of evidence, 4. Methods: A retrospective cohort of National Football League (NFL) players with ACL injuries from 3 consecutive seasons (2013-2016) was populated by searching publicly available online databases and other traditional media sources. Of 156 ACL injuries identified, 77 occurred during the regular season and playoffs, with video analysis available for 69 injuries. The video of each injury was independently viewed by 2 reviewers to determine the nature of the injury (ie, whether it occurred via a noncontact mechanism), the position of the lower extremity, and the football activity at the time of injury. Playing surface, player position, and time that the injury occurred were also recorded. Results: Contrary to our hypothesis, the majority of ACL injuries occurred via a noncontact mechanism (50 of 69, 72.5%), with the exception of injury to offensive linemen, who had a noncontact mechanism in only 20% of injuries. For noncontact injuries, the most common football activity at the time of injury was pivoting/cutting, and the most common position of the injured extremity included hip abduction/flexion, early knee flexion/abduction, and foot abduction/external rotation. There was no association between injury mechanism and time of injury or playing surface in this cohort. Conclusion: In this study of players in the NFL, the majority of ACL tears involved a noncontact mechanism, with the lower extremity exhibiting a dynamic valgus moment at the knee. These findings suggest that ACL injury prevention programs may reduce the risk of noncontact ACL tears in American football players.

scholarly journals Video Analysis of Anterior Cruciate Ligament (ACL) Injuries

JBJS Reviews ◽  
2016 ◽  
Vol 4 (11) ◽  
Author(s):  
Victor R. Carlson ◽  
Frances T. Sheehan ◽  
Barry P. Boden
Keyword(s):  
Anterior Cruciate Ligament ◽  
Video Analysis ◽  
Cruciate Ligament ◽  
Acl Injuries ◽  
Anterior Cruciate

Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Female Soccer Players

2021 ◽  
pp. 036354652110081
Author(s):  
Simona Lucarno ◽  
Matteo Zago ◽  
Matthew Buckthorpe ◽  
Alberto Grassi ◽  
Filippo Tosarelli ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Direct Contact ◽  
Cruciate Ligament ◽  
Case Series ◽  
Biomechanical Analysis ◽  
Soccer Players ◽  
Indirect Contact ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
Women's Soccer

Background: Female soccer players are particularly susceptible to anterior cruciate ligament (ACL) injuries, accounting for 16% to 43% of the injury burden during the season. Despite the advancements in injury prevention programs, the rate of ACL injuries continues to rise. Purpose: To provide a comprehensive description of the mechanisms, situational pattern, and biomechanics of ACL injuries in women’s soccer. Study Design: Case series; Level of evidence, 4. Methods: We identified 57 consecutive ACL injuries that occurred in matches of 6 top female leagues across 3 seasons (2017-2020). A total of 35 (61%) injury videos were analyzed for the mechanism and situational pattern, while biomechanical analysis was possible in 29 cases. Three independent reviewers evaluated each video. The distribution of ACL injuries according to month, timing within the match, and field location at the time of injury was also reported. Results: In the 35 injury videos, there were 19 (54%) noncontact injuries, 12 (34%) indirect contact injuries, and 4 (11%) direct contact injuries. We identified 3 main situations in players who suffered a noncontact/indirect contact injury: (1) pressing and tackling (n = 18), (2) regaining balance after kicking (n = 7), and (3) being tackled (n = 4). Biomechanical analysis indicated multiplanar mechanisms with frequent knee valgus loading (88%). Additionally, 64% of injuries occurred in the first half of matches and most frequently within the first 30 minutes. Conclusion: Female athletes showed remarkable similarities with elite male players in terms of the ACL mechanism and situational pattern of injury, and 88% of injuries involved no direct contact to the knee, with noncontact injuries being highly prevalent. Injuries occurred during 3 main situations, with accompanying alterations in multiplanar biomechanics. Interventions aimed at reducing ACL injuries in women’s soccer should consider high-intensity defensive play at the beginning of a match. Instruction in the 3 main situations should be applied alongside appropriate neuromuscular training interventions.

High Incidence of Anterior Cruciate Ligament Injuries Within the First 2 Months of the Season in Amateur Team Ball Sports

2021 ◽  
pp. 194173812110141
Author(s):  
Caroline Mouton ◽  
Alli Gokeler ◽  
Anouk Urhausen ◽  
Christian Nührenbörger ◽  
Romain Seil
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Case Series ◽  
Chi Square ◽  
Level Of Evidence ◽  
Acl Injuries ◽  
Anterior Cruciate Ligament Injuries ◽  
Injury Occurrence ◽  
Anterior Cruciate ◽  
Acl Injury Prevention

Background: The incidence of anterior cruciate ligament (ACL) injuries is commonly reported as an annual incidence rate. There is relatively little information about the seasonal aspects of these injuries. The aim of the current study was to analyze the distribution of ACL injuries during the season in nonprofessional soccer, handball, and basketball based on a retrospective analysis of a hospital-based registry. Hypothesis: ACL injuries in soccer, handball, and basketball were more common within the first 2 months of the season in comparison with the rest of the year. Study Design: Case series. Level of Evidence: Level 4. Methods: Injury occurrence during the calendar year was divided into 6 periods of 2 months, with segment 1 (S1) representing the first 2 months of the season. For soccer, S1 corresponded to September and October. The season started 1 month later for handball and basketball, so S1 represented October and November. Chi-square tests were used to analyze the distribution of ACL injuries among segments according to gender, age, sports, and injury mechanism (contact/noncontact). Results: A total of 371 ACL injuries were included (soccer, 258, handball, 56, basketball, 57). Overall, the distribution of ACL injuries was not uniform across the segments ( P < 0.01). Almost one-third of the ACL injuries occurred in S1 (n = 104; 28%). Significant differences could be observed according to sports ( P < 0.01). There were fewer ACL injuries in S2 for soccer compared with basketball ( P < 0.05). In S5, there were significantly more ACL injuries in soccer compared with handball and basketball ( P < 0.05). Conclusion: A high occurrence of ACL injuries was reported immediately within the first 2 months of the season in nonprofessional soccer, handball, and basketball sports. Clinical Relevance: These findings indicate that ACL injury prevention programs should be started in the preseason period to allow for gradual increases of load.

scholarly journals Autograft diameter in ACL reconstruction: size does matter

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 16
Author(s):  
Fahad N.A. Alkhalaf ◽  
Sager Hanna ◽  
Mohammed Saleh Hattab Alkhaldi ◽  
Fares Alenezi ◽  
Aliaa Khaja
Keyword(s):  
Anterior Cruciate Ligament ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Case Series ◽  
Failure Rates ◽  
Graft Size ◽  
Level Of Evidence ◽  
Acl Injuries ◽  
Tertiary Center ◽  
Anterior Cruciate

Background: Anterior cruciate ligament injuries are commonly seen in orthopedic surgery practice. Although anterior cruciate ligament reconstruction (ACLR) has come a long way, the causes of failure have yet to be fully understood. Objective: The aim of this study was to investigate whether or not the intraoperative 4-strand hamstring autograft diameter does in fact influence the failure rates of ACLR. Methods: Retrospective intraoperative data were collected from ACLR patients from the only tertiary center available in Kuwait. Patients who underwent ACLR from 2012 to 2018 for isolated ACL injuries were included in this study, allowing for a 24 month follow-up period The cohorts were categorized into 3 groups: patients with graft size≤8mm, 2, patients with graft sizes≥8mm with 4-strands and patients with graft sizes≥8mm with 4-strands or more. ANOVA analysis was applied to address group differences between mean graft size and strand numbers and subsequently the failure rates for each group. In addition, the Mann–Whitney U test was used to investigate the relationship between revision and initial ACL graft size. Results: Out of the 711 out of 782 patients were included in this study. Only 42.6% of the patients did not need more than 4-strands to achieve an 8mm sized autograft. The patients who had autografts≤8mm in this study accounted for 17.1% of the population. About 7.2% of these patients required revision surgery. Patients with a 4-strand autograft size that was less than 8mm were 7.2 times more at risk for ACLR failure (RR=7.2, 95% CI: 6.02; 8.35, p=0.007). Conclusions: There is a significant correlation between 4-strand autograft diameter size and the need for ACLR revision surgery. Level of evidence: IV case series

A prospective evaluation of clinical and functional outcome of single bundle anatomic anterior cruciate ligament reconstruction with hamstrings autograft

2020 ◽  
pp. 1-17
Author(s):  
Saeed Ahmed Shaikh ◽  
Naveed Ahmed ◽  
Salman Adil ◽  
Allah Rakhio Jamali
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Outcomes ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Single Bundle ◽  
Acl Injuries ◽  
Lysholm Knee Score ◽  
Anterior Cruciate ◽  
Multiligamentous Injury

Abstract A case series was conducted at the Department of Orthopaedic surgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2016 to June 2018, to evaluate the functional and clinical outcome of arthroscopic anatomic anterior cruciate ligament (ACL) reconstruction with hamstrings autograft. Patients aged 17 years and above with anterior cruciate ligament (ACL) injuries of duration three months or older, diagnosed on history and clinical examination and confirmed on Magnetic Resonance Imaging were prospectively recruited from outpatient department. Patients with multiligamentous injury were excluded. Information on patient’s demographics such as age, duration of injury and mechanism of injury were recorded. In addition, graft length and diameter, associated injuries of lateral or medical menisci were noted peroperatively. Patients were followed for a minimum of 12 months. The functional outcomes were assessed thorough lysholm knee score, and Tegner activity scale.Continuous...  

Video Analysis of Anterior Cruciate Ligament Tears in Professional American Football Athletes: Response

2018 ◽  
Vol 46 (14) ◽  
pp. NP73-NP74 ◽  
Author(s):  
Robert H. Brophy ◽  
Jeffrey T. Johnston ◽  
David Schub ◽  
Scott A. Rodeo ◽  
Matthew J. Matava ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Video Analysis ◽  
Cruciate Ligament ◽  
American Football ◽  
Anterior Cruciate ◽  
Cruciate Ligament Tears

scholarly journals Return to High School– and College-Level Football After Anterior Cruciate Ligament Reconstruction

2012 ◽  
Vol 40 (11) ◽  
pp. 2523-2529 ◽  
Author(s):  
Kirk A. McCullough ◽  
Kevin D. Phelps ◽  
Kurt P. Spindler ◽  
Matthew J. Matava ◽  
Warren R. Dunn ◽  
...  
Keyword(s):  
High School ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Performance Level ◽  
American Football ◽  
Return To Play ◽  
Football Players ◽  
Patient Reported ◽  
Anterior Cruciate

Background: There is a relative paucity of data regarding the effect of anterior cruciate ligament (ACL) reconstruction on the ability of American high school and collegiate football players to return to play at the same level of competition as before their injury or to progress to play at the next level of competition. Purpose: (1) To identify the percentage of high school and collegiate American football players who successfully returned to play at their previous level of competition, (2) to investigate self-reported performance for those players able to return to play or reason(s) for not returning to play, and (3) to elucidate risk factors responsible for players not being able to return to play or not returning to the same level of performance. Study Design: Cohort study; Level of evidence, 3. Methods: This study was a retrospective analysis of prospective patients taken from the Multicenter Orthopaedic Outcomes Network (MOON) cohort who identified football as their primary or secondary sport. Identified patients were then questioned in a structured interview regarding their ACL injury, participation in football before their injury, and factors associated with returning to play. Data were analyzed for player position, concurrent meniscal/ligamentous/chondral injury, surgical technique and graft used for ACL reconstruction, and issues pertaining to timing and ability to return to play. Results: One hundred forty-seven players (including 68 high school and 26 collegiate) met our criteria and were contacted from the 2002 and 2003 MOON cohorts. Return to play rates for all high school and collegiate athletes were similar (63% and 69%, respectively). Based on player perception, 43% of the players were able to return to play at the same self-described performance level. Approximately 27% felt they did not perform at a level attained before their ACL tear, and 30% were unable to return to play at all. Although two thirds of players reported some “other interest” contributing to their decision not to return, at both levels of competition, fear of reinjury or further damage was cited by approximately 50% of the players who did not return to play. Analysis of patient-reported outcome scores at a minimum of 2 years after surgery between patients who returned to play and those who did not demonstrated clinically and statistically significant differences in the International Knee Documentation Committee form, Marx Activity Scale, and Knee injury and Osteoarthritis Outcome Score knee-related quality of life subscale in the collegiate players. Similar clinical differences were not statistically significant in the high school students. Player position did not have a statistically significant effect on the ability to return to play for high school players, and 41% of “skilled” position players and 50% of “nonskilled” position players were able to return to play at the same performance level. Conclusion: Return to play percentages for amateur American football players after ACL reconstruction are not as high as would be expected. While technical aspects of ACL reconstruction and the ensuing rehabilitation have been studied extensively, the psychological factors (primarily a fear of reinjury) influencing the ability to return to play after ACL surgery may be underestimated as a critical factor responsible for athletes not returning to play at any level of competition.

Differences in Kinematics and Electromyographic Activity between Men and Women during the Single-Legged Squat

2003 ◽  
Vol 31 (3) ◽  
pp. 449-456 ◽  
Author(s):  
Brian L. Zeller ◽  
Jean L. McCrory ◽  
W. Ben Kibler ◽  
Timothy L. Uhl
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Muscle Activation ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Rectus Femoris ◽  
Ligament Injury ◽  
Electromyographic Activity ◽  
Men And Women ◽  
Anterior Cruciate

Background Numerous factors have been identified as potentially increasing the risk of anterior cruciate ligament injury in the female athlete. However, differences between the sexes in lower extremity coordination, particularly hip control, are only minimally understood. Hypothesis There is no difference in kinematic or electromyographic data during the single-legged squat between men and women. Study Design Descriptive comparison study. Methods We kinematically and electromyographically analyzed the single-legged squat in 18 intercollegiate athletes (9 male, 9 female). Subjects performed five single-legged squats on their dominant leg, lowering themselves as far as possible and then returning to a standing position without losing balance. Results Women demonstrated significantly more ankle dorsiflexion, ankle pronation, hip adduction, hip flexion, hip external rotation, and less trunk lateral flexion than men. These factors were associated with a decreased ability of the women to maintain a varus knee position during the squat as compared with the men. Analysis of all eight tested muscles demonstrated that women had greater muscle activation compared with men. When each muscle was analyzed separately, the rectus femoris muscle activation was found to be statistically greater in women in both the area under the linear envelope and maximal activation data. Conclusions Under a physiologic load in a position commonly assumed in sports, women tend to position their entire lower extremity and activate muscles in a manner that could increase strain on the anterior cruciate ligament.

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