The Combined Effect of Body Mass Index and Tibial Slope Angles on Anterior Cruciate Ligament Injury Risk in Male Knees: A Case-Control Study

Introduction: Tibial slope angles (TSAs) have been identified as potential risk factors of anterior cruciate ligament (ACL) injury in the literature. A higher body mass index (BMI) might increase the risk of ACL tear because of greater axial compressive force. The aim of this study was to determine the relationship of these factors and the combined effect of BMI and TSA in determination of risk potential for ACL injury. Methods: The preoperative magnetic resonance (MR) images of 81 ACL-injured male knees and of 68 male individuals with no ACL injuries were evaluated by 2 radiologists to measure the TSA. The Mann-Whitney U-test was performed to indicate the significant difference in height, weight, and BMI values. The independent samples t-test was used to determine the differences between ACL-injured and non-injured groups regarding TSA values. Odds ratios were calculated by logistic regression tests, and receiver operating characteristics (ROC) curves revealed the area under the receiver operating characteristics curve (AUC) values to compare the relationships of these parameters with ACL injury. Results: Body mass index, lateral tibial slope (LTS), and medial tibial slope (MTS) were predictive of ACL risk injury. Body mass index alone had the greatest effect among these parameters, and there were no statistically significant differences in coronal tibial slope values between the ACL-ruptured and control groups. The greatest AUC was observed for the combination of BMI, MTS, and LTS. Conclusions: Body mass index, LTS, and MTS angles were associated with ACL injury risk and BMI + MTS + LTS together revealed the greatest effect on ACL injury.

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Longitudinal Assessment of Noncontact Anterior Cruciate Ligament Injury Risk Factors During Maturation in a Female Athlete: A Case Report

Journal of Athletic Training ◽

10.4085/1062-6050-44.1.101 ◽

2009 ◽

Vol 44 (1) ◽

pp. 101-109 ◽

Cited By ~ 41

Author(s):

Gregory D. Myer ◽

Kevin R. Ford ◽

Jon G. Divine ◽

Eric J. Wall ◽

Leamor Kahanov ◽

...

Keyword(s):

Risk Factors ◽

Anterior Cruciate Ligament ◽

Body Mass ◽

Female Athlete ◽

Injury Risk ◽

Cruciate Ligament ◽

Acl Injury ◽

Knee Abduction ◽

Injury Risk Factors ◽

Anterior Cruciate

Abstract Objective: To present a unique case of a young pubertal female athlete who was prospectively monitored for previously identified anterior cruciate ligament (ACL) injury risk factors for 3 years before sustaining an ACL injury. Background: In prospective studies, previous investigators have examined cross-sectional measures of anatomic, hormonal, and biomechanical risk factors for ACL injury in young female athletes. In this report, we offer a longitudinal example of measured risk factors as the participant matured. Differential Diagnosis: Partial or complete tear of the ACL. Measurements: The participant was identified from a cohort monitored from 2002 until 2007. No injury prevention training or intervention was included during this time in the study cohort. Findings: The injury occurred in the year after the third assessment during the athlete's club basketball season. Knee examination, magnetic resonance imaging findings, and arthroscopic evaluation confirmed a complete ACL rupture. The athlete was early pubertal in year 1 of the study and pubertal during the next 2 years; menarche occurred at age 12 years. At the time of injury, she was 14.25 years old and postpubertal, with closing femoral and tibial physes. For each of the 3 years before injury, she demonstrated incremental increases in height, body mass index, and anterior knee laxity. She also displayed decreased hip abduction and knee flexor strength, concomitant with increased knee abduction loads, after each year of growth. Conclusions: During puberty, the participant increased body mass and height of the center of mass without matching increases in hip and knee strength. The lack of strength and neuromuscular adaptation to match the increased demands of her pubertal stature may underlie the increased knee abduction loads measured at each annual visit and may have predisposed her to increased risk of ACL injury.

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Plyometrics Did Not Improve Jump-Landing Biomechanics in Individuals With a History of Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2020-0072 ◽

2021 ◽

pp. 1-8

Author(s):

Hyunjae Jeon ◽

Sean Krysak ◽

Steven J. Pfeiffer ◽

Abbey C. Thomas

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Body Mass ◽

Cruciate Ligament ◽

Acl Injury ◽

Jump Landing ◽

History Of ◽

Anterior Cruciate

Second anterior cruciate ligament (ACL) injury has similar biomechanical risk factors as primary injury. Standard of care rehabilitation does not adequately mitigate these biomechanical risks. This study examined the effectiveness of a 4-week plyometric intervention on biomechanical risk factors of second ACL injury versus no intervention in patients with a history of ACL reconstruction. Thirty adults post-ACL reconstruction received 12 sessions of plyometric (age: 19.9 ± 1.62 years; body mass index: 23.9 ± 2.6 kg/m2; months postoperative: 35.7 ± 24.2) or no (age: 21.3 ± 3.5 years; body mass index: 27.7 ± 4.8 kg/m2; months postoperative: 45.3 ± 25.4) exercise intervention. Hip and knee biomechanics were quantified during a jump-landing task before and after the intervention. Individual response to the intervention was evaluated via minimal detectable change. Hip flexion angle had the greatest response to plyometric training. Overall, focused plyometric intervention did not adequately mitigate biomechanical risk factors of second ACL injury; thus, development of interventions capable of modifying biomechanics known to contribute to ACL injury risk remains necessary.

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Hubungan Indeks Massa Tubuh dengan Cedera Ligamen Krusiat Anterior pada Atlet Cabang Olahraga Kontak

Jurnal Kesehatan Andalas ◽

10.25077/jka.v5i3.589 ◽

2016 ◽

Vol 5 (3) ◽

Author(s):

Rurin Ardiyanti ◽

Afriwardi Afriwardi ◽

Nur Afrainin Syah

Keyword(s):

Body Mass Index ◽

Risk Factor ◽

Body Mass ◽

Injury Risk ◽

Cruciate Ligament ◽

Acl Injury ◽

Acl Injuries ◽

Injury Risk Factor ◽

Anterior Cruciate ◽

High Bmi

AbstrakCedera Ligamen Krusiat Anterior (LKA) adalah trauma pada atlet yang memerlukan tindakan bedah dan berrisiko menjadi osteoartritis. Berbagai macam faktor dapat menyebabkan cedera LKA, seperti Indeks Massa Tubuh (IMT) yang merupakan salah satu faktor risiko cedera LKA. Tujuan penelitian ini adalah menentukan hubungan IMT dengan cedera LKA. Penelitian ini menggunakan metode analitik observasional. Sampel adalah 271 atlet diambil dari seluruh cabang olahraga kontak di KONI (Komite Olahraga Nasional Indonesia) Jawa Timur. Data yang diperoleh berupa IMT dan kejadian cedera LKA pada atlet dalam 1 tahun, kemudian dianalisis dengan uji kemaknaan Fisher. Peneliti menemukan 7% (19 orang) mengalami cedera LKA. Penelitian ini menemukan bahwa presentase cedera LKA pada IMT tinggi (>24,9 kg/m2) dua kali lebih banyak dibanding pada IMT tidak tinggi (≤24,9 kg/m2), yaitu 12,5% dan 6,5%. Pada uji Fisher tidak ditemukan hubungan antara IMT dan cedera LKA (p>0,05). Penelitian ini menunjukkan bahwa terdapat risiko cedera LKA pada atlet dengan IMT tinggi, namun tidak signifikan secara statistik. Banyak faktor risiko cedera LKA lainnya yang tidak dapat dikontrol melalui metodologi penelitian ini.Kata kunci: indeks massa tubuh, cedera ligamen krusiat anterior, atlet AbstractAnterior Cruciate Ligament (ACL) injuries are common on athletes that need surgical treatment and a risk to become osteoarthritis. There are many factors contributed to ACL injury. Body Mass Index (BMI) is one of ACL injury risk factor. The objective of this study was to determine the relationship between BMI and ACL injury. This was an observasional analitic study. The sample was 271 contact sport athletes at KONI East Java. Data about BMI and ACL injury on the athlete for 1 year was collected. The data then was analysed by Fisher test. There were 7% (19 persons) of athletes suffers from ACL injury. This study found that the proportion of ACL injury on athlete with high BMI (>24,9 kg/m2) was twice compared to athlete without high BMI (≤24,9 kg/m2), 12,5% and 6,3% respectively. The conclusion is the different is not significant statitically. This study showed that high BMI on athletes was a risk factor for ACL injury but not significant statistically.Keywords: body mass index, anterior cruciate ligament, athlete

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Electromyographic Assessment of Anterior Cruciate Ligament Injury Risk in Male Tennis Players: Which Role for Visual Input? A Proof-of-Concept Study

Diagnostics ◽

10.3390/diagnostics11060997 ◽

2021 ◽

Vol 11 (6) ◽

pp. 997

Author(s):

Alessandro de Sire ◽

Nicola Marotta ◽

Andrea Demeco ◽

Lucrezia Moggio ◽

Pasquale Paola ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Injury Risk ◽

Cruciate Ligament ◽

Acl Injury ◽

Visual Input ◽

Proof Of Concept ◽

Tennis Players ◽

Concept Study ◽

Acl Injury Risk ◽

Anterior Cruciate

Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in the assessment of the risk of ACL injury. Therefore, this proof-of-concept study aimed at evaluating the role of visual input on the thigh muscle preactivation through sEMG to reduce ACL injury risk in tennis players. We recruited male, adult, semiprofessional tennis players from July to August 2020. They were asked to drop with the dominant lower limb from a step, to evaluate—based on dynamic valgus stress—the preactivation time of the rectus femoris (RF), vastus medialis, biceps femoris, and medial hamstrings (MH), through sEMG. To highlight the influence of visual inputs, the athletes performed the test blindfolded and not blindfolded on both clay and grass surfaces. We included 20 semiprofessional male players, with a mean age 20.3 ± 4.8 years; results showed significant early muscle activation when the subject lacked visual input, but also when faced with a less-safe surface such as clay over grass. Considering the posteromedial–anterolateral relationship (MH/RF ratio), tennis players showed a significant higher MH/RF ratio if blindfolded (22.0 vs. 17.0% not blindfolded; p < 0.01) and percentage of falling on clay (17.0% vs. 14.0% in grass; p < 0.01). This proof-of-principle study suggests that in case of absence of visual input or falling on a surface considered unsafe (clay), neuro-activation would tend to protect the anterior stress of the knee. Thus, the sEMG might play a crucial role in planning adequate athletic preparation for semiprofessional male athletes in terms of reduction of ACL injury risk.

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Relationships between vastus medialis fat infiltration with body mass index, disease severity and anterior cruciate ligament status in patients with knee osteoarthritis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2019.02.750 ◽

2019 ◽

Vol 27 ◽

pp. S342-S343

Author(s):

A. Teoli ◽

S. Robbins ◽

F. Abram ◽

J.-P. Pelletier ◽

J. Martel-Pelletier

Keyword(s):

Body Mass Index ◽

Anterior Cruciate Ligament ◽

Knee Osteoarthritis ◽

Disease Severity ◽

Body Mass ◽

Cruciate Ligament ◽

Vastus Medialis ◽

Fat Infiltration ◽

Anterior Cruciate ◽

Index Disease

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Diagnostic of Injury Risk in the Anterior Cruciate Ligament Based On Shape Context Description of the Intercondylar Notch Curvature

Journal of Engineering and Science in Medical Diagnostics and Therapy ◽

10.1115/1.4053063 ◽

2021 ◽

Author(s):

Joao Paulo Dias ◽

Ariful Bhuiyan ◽

Nabila Shamim

Keyword(s):

Anterior Cruciate Ligament ◽

Injury Risk ◽

Cruciate Ligament ◽

Acl Injury ◽

False Positives ◽

Intercondylar Notch ◽

Mr Images ◽

Shape Context ◽

Similarity Factor ◽

Anterior Cruciate

Abstract An estimated number of 300,000 new anterior cruciate ligament (ACL) injuries occur each year in the United States. Although several magnetic resonance (MR) imaging-based ACL diagnostics methods have already been proposed in the literature, most of them are based on machine learning or deep learning strategies, which are computationally expensive. In this paper, we propose a diagnostics framework for the risk of injury in the anterior cruciate ligament (ACL) based on the application of the inner-distance shape context (IDSC) to describe the curvature of the intercondylar notch from MR images. First, the contours of the intercondylar notch curvature from 91 MR images of the distal end of the femur (70 healthy and 21 with confirmed ACL injury) were extracted manually using standard image processing tools. Next, the IDSC was applied to calculate the similarity factor between the extracted contours and reference standard curvatures. Finally, probability density functions of the similarity factor data were obtained through parametric statistical inference, and the accuracy of the ACL injury risk diagnostics framework was assessed using receiver operating characteristic analysis (ROC). The overall results for the area under the curve (AUC) showed that method reached a maximum accuracy of about 66%. Furthermore, the sensitivity and specificity results showed that an optimum discrimination threshold value for the similarity factor can be pursued that minimizes the incidence of false positives and false positives simultaneously.

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Examining the Dynamic Nature of Anterior Cruciate Ligament Injury Risk Factors in Women’s Collegiate Soccer

Journal of Sport Rehabilitation ◽

10.1123/jsr.2021-0110 ◽

2021 ◽

pp. 1-8

Author(s):

Elena M. D’Argenio ◽

Timothy G. Eckard ◽

Barnett S. Frank ◽

William E. Prentice ◽

Darin A. Padua

Keyword(s):

Risk Factors ◽

Anterior Cruciate Ligament ◽

Range Of Motion ◽

Injury Risk ◽

External Rotation ◽

Cruciate Ligament ◽

Acl Injury ◽

Dynamic Risk Factors ◽

Dynamic Risk ◽

Anterior Cruciate

Context: Anterior cruciate ligament (ACL) injuries are a common and devastating injury in women’s soccer. Several risk factors for ACL injury have been identified, but have not yet been examined as potentially dynamic risk factors, which may change throughout a collegiate soccer season. Design: Prospective cohort study. Methods: Nine common clinical screening assessments for ACL injury risk, consisting of range of motion, movement quality, and power, were assessed in 29 Division I collegiate women’s soccer players. Preseason and midseason values were compared for significant differences. Change scores for each risk factor were also correlated with cumulative training loads during the first 10 weeks of a competitive soccer season. Results: Hip external rotation range of motion and power had statistically significant and meaningful differences at midseason compared with preseason, indicating they are dynamic risk factors. There were no significant associations between the observed risk factor changes and cumulative training load. Conclusions: Hip external rotation range of motion and power are dynamic risk factors for ACL injury in women’s collegiate soccer athletes. Serial screening of these risk factors may elucidate stronger associations with injury risk and improve prognostic accuracy of screening tools.

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