scholarly journals Hip Angle Behavior in Landing After Drop Jump in Children; and their Implicance in Prevention Programs

2019 ◽  
Vol 1 (1) ◽  
pp. 11-21
Author(s):  
Jair Burboa G ◽  
Matias Bahamondes F ◽  
Mauricio Inostroza M ◽  
Paloma Lillo U ◽  
Jaime Hinzpeter
Keyword(s):  
Risk Factors ◽  
Cruciate Ligament ◽  
Training Session ◽  
Acl Injury ◽  
Physical Load ◽  
Drop Jump ◽  
Protective Capacity ◽  
Level Of Evidence ◽  
Before And After ◽  
Hip Flexion

Background The Anterior Cruciate Ligament (ACL) injury is uncommon, but constitutes an important percentage of the lesions requiring more than 8 weeks of recovery in sports. Most ACL injuries do not require external contact and are associated with biomechanical risk factors that stress this ligament ACL: like an increase in knee valgus angle (KV) and hip flexion (HF) and a decreased in knee flexion (KF). The ACL requires muscle cooperation to resist the load; however, when there is fatigue, the protective capacity of the musculature would decrease. The objective of the study is to analyze the angular behavior before and after a physical load for HF in children of 14-15 years old. Hypothesis The physical load applied in a single training session is enough to change some biomechanical risk factors of ACL injury. Study Design Experimental study Level of Evidence 2b Methods The sample consisted of 50 students from different soccer schools between 14-15 years old. We analyzed the hip angular behavior of hip flexion before and after a training session. The angles where obtained from inertioal sensor while the students performed a Drop Jump test from a 30 centimeters drawer. Results Statistically significant differences were found in the differences between pre physical load HF / post-load HF (p = 0.00053), right pre physical load HF / right post- load HF (p = 0.0086) and left post- load (p = 0.0248206). Conclusions It was concluded that the angular behavior of HF increases significantly in both post-training limbs, after performing a physical load. Clinical Relevance This study analyzed the importance of using prevention injury programs since early stages, and give importance to the eccentric role of hamstring, gluteus and core exercises.

Four Risk Factors for Arthrofibrosis in Tibial Spine Fractures: A National 10-Site Multicenter Study

2020 ◽  
Vol 48 (12) ◽  
pp. 2986-2993
Author(s):  
Joshua T. Bram ◽  
Julien T. Aoyama ◽  
R. Justin Mistovich ◽  
Henry B. Ellis ◽  
Gregory A. Schmale ◽  
...  
Keyword(s):  
Risk Factors ◽  
Operating Room ◽  
Multicenter Study ◽  
Cruciate Ligament ◽  
Traumatic Injury ◽  
Acl Injury ◽  
Spine Fractures ◽  
Cast Immobilization ◽  
Level Of Evidence ◽  
Tibial Spine

Background: Tibial spine fractures (TSFs) are relatively rare pediatric injuries. Postoperative arthrofibrosis remains the most common complication, with few studies having examined factors associated with its development. Purpose: To identify risk factors for arthrofibrosis and required MUA or lysis of adhesions in the largest known cohort of patients with TSFs. Study Design: Case-control study; Level of evidence, 3. Methods: This was a multicenter study of 249 patients ≤18 years old who had a TSF between January 2000 and February 2019. Patients were separated into cohorts based on whether they developed arthrofibrosis, defined as a 10° deficit in extension and/or 25° deficit in flexion at postoperative 3 months or a return to the operating room for manipulation under anesthesia (MUA) and/or lysis of adhesions. Results: A total of 58 (23.3%) patients developed postoperative arthrofibrosis, with 19 (7.6%) requiring a return to the operating room for MUA. Patients with arthrofibrosis were younger (mean ± SD, 11.3 ± 2.7 vs 12.3 ± 2.8 years; P = .029). They were more likely to have a nonsport, trauma-related injury (65.4% vs 32.1%; P < .001) and a concomitant ACL injury (10.3% vs 1.1%; P = .003). Those with arthrofibrosis had longer operative times (135.0 vs 114.8 minutes; P = .006) and were more likely to have been immobilized in a cast postoperatively (30.4% vs 16.6%; P = .043). In multivariate regression, concomitant anterior cruciate ligament (ACL) injury (odds ratio [OR], 20.0; P = .001), traumatic injury (OR, 3.8; P < .001), age <10 years (OR, 2.2; P = .049), and cast immobilization (OR, 2.4; P = .047) remained significant predictors of arthrofibrosis. Concomitant ACL injury (OR, 7.5; P = .030) was additionally predictive of a required return to the operating room for MUA. Conclusion: Surgeons should be cognizant of arthrofibrosis risk in younger patients with concomitant ACL tears and traumatic injuries not resulting from athletics. Furthermore, postoperative immobilization in a cast should be avoided given the high risk of arthrofibrosis. Concomitant ACL injury is associated with a higher return to the operating room for MUA.

scholarly journals Biomechanical Deficits at the Hip in Athletes With ACL Reconstruction Are Ameliorated With Neuromuscular Training

2018 ◽  
Vol 46 (11) ◽  
pp. 2772-2779 ◽  
Author(s):  
Christopher Nagelli ◽  
Samuel Wordeman ◽  
Stephanie Di Stasi ◽  
Joshua Hoffman ◽  
Tiffany Marulli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Flexion Angle ◽  
Control Group ◽  
Hip Biomechanics ◽  
Main Effect ◽  
Anterior Cruciate ◽  
Hip Flexion ◽  
And Control

Background: The efficacy of a neuromuscular training (NMT) program to ameliorate known hip biomechanical risk factors for athletes with anterior cruciate ligament reconstruction (ACLR) is currently unknown. Purpose/Hypothesis: The purpose was to quantify the effects of an NMT program on hip biomechanics among athletes with ACLR and to compare posttraining hip biomechanics with a control group. The hypotheses were that known hip biomechanical risk factors of anterior cruciate ligament (ACL) injury would be significantly reduced among athletes with ACLR after the NMT program and that posttraining hip biomechanics between the ACLR and control cohorts would not differ. Study Design: Controlled laboratory study. Methods: Twenty-eight athletes (n = 18, ACLR; n = 10, uninjured) completed a 12-session NMT program. Biomechanical evaluation of a jump-landing task was done before and after completion of the program. Repeated measures analysis of variance was performed to understand the effect of NMT within the ACLR cohort. Two-way analysis of variance was used to compare both groups. Post hoc testing was done for significant interactions. Hip biomechanical variables at initial contact are reported. Results: The athletes with ACLR who completed the NMT program had a significant session × limb interaction ( P = .01) for hip external rotation moment and a significant main effect of session for hip flexion angle ( P = .049) and moment ( P < .001). There was a significant change for the involved ( P = .04; 528% increase) and uninvolved ( P = .04; 57% decrease) limbs from pre- to posttraining for hip rotation moment. The ACLR cohort had an increase in hip flexion angle (14% change) and a decrease in hip flexion moment (65% change) from pre- to posttraining. Posttraining comparison for these same hip biomechanical variables of interest revealed no significant interactions ( P > .05) between the ACLR and control cohorts. There was a significant main effect of group ( P = .02) for hip flexion angle, as the ACLR cohort demonstrated greater hip flexion angle than that of the control group. Conclusion: For athletes with ACLR, hip biomechanical measures of ACL injury risk show significant improvements after completion of an NMT program. Clinical Relevance: Athletes with ACLR who are participating in an NMT program may ameliorate known hip biomechanical risk factors for an ACL injury.

scholarly journals Comparison of the Angular Compartment of Hip Flexion Before and After Training in 11 to 12-Year-old Soccer Players.

2019 ◽  
Vol 1 (1) ◽  
pp. 4-10
Author(s):  
Jair Burboa G ◽  
Mauricio Inostroza M ◽  
Matías Bahamondes F ◽  
Paloma Lillo U ◽  
Jaime Hinzpeter C
Keyword(s):  
Inertial Sensors ◽  
Cruciate Ligament ◽  
Training Session ◽  
Neuromuscular Control ◽  
School Students ◽  
Acl Injuries ◽  
Randomized Clinical Study ◽  
Jump Test ◽  
Before And After ◽  
Hip Flexion

An anterior cruciate ligament (ACL) injury is an important cause of rest in athletes. In most cases, ACL injuries do not require external contact and they are associated with biomechanical risk factors that increase ACL tension. The increase of the hip flexion angle (HF) is included within these. The ACL requires cooperation of the periarticular musculature of the knee, muscle groups, hip stabilizers and CORE muscles; consequently, fatigue caused by exercise would alter the balance and put this ligament at risk. The objective of the study is to determine the angular behavior for HF before and after a physical load (a standardized training) in children between 11 and 12 years old. A non-randomized clinical study was carried out. The sample consisted of 50 soccer school students born between 11 and 12 years old. The angular behavior of HF was compared before and after performing a training session. The angular behavior was measured through the Drop Jump test (DJ), with data obtained by inertial sensors. After the exercise, there was a significant increase in HF. It was concluded that the angular behavior of HF increases significantly in both extremities after training and that preventive measures must be applied for neuromuscular control of the hip.

scholarly journals Alpine Ski Racing Injuries

2019 ◽  
Vol 11 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Mitchell C. Tarka ◽  
Annabelle Davey ◽  
Geordie C. Lonza ◽  
Casey M. O’Brien ◽  
John P. Delaney ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injury Prevention ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Acl Injury ◽  
Prevention Strategies ◽  
Level Of Evidence ◽  
Acl Injuries ◽  
Ski Racers

Context: This article reviews the epidemiology of alpine ski racing–related injuries, risk factors, mechanisms of injury, and injury prevention strategies. Evidence Acquisition: Pertinent literature from peer-reviewed publications from 1976 through 2018. Study Design: Clinical review. Level of Evidence: Level 5. Results: The rate of injury in alpine ski racing is high. In general, knee injuries are the most common, with anterior cruciate ligament (ACL) disruptions being the most significant in terms of time loss from sport. Three specific mechanisms of ACL injury in alpine ski racers have recently been described (slip-catch, dynamic snowplow, and landing back-weighted). In contrast to other sports, female ski racers are not clearly at greater risk for ACL injury, especially at the highest level of competition. A high percentage of ski racers are able to return to their previous level of competition after ACL injury. Risk factors for injury and methods of injury prevention have been proposed; however, the rate of injury, particularly ACL injuries, has not decreased significantly. Conclusion: Alpine ski racing has a high injury rate. ACL injuries in particular remain problematic. Further study is needed to identify modifiable risk factors and implementation of injury prevention strategies.

scholarly journals ACL Size and Notch Width Between ACLR and Healthy Individuals: A Pilot Study

2019 ◽  
Vol 12 (1) ◽  
pp. 61-65
Author(s):  
Hsin-Min Wang ◽  
Sandra J. Shultz ◽  
Scott E. Ross ◽  
Robert A. Henson ◽  
David H. Perrin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Size ◽  
Effect Size ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Healthy Individuals ◽  
Level Of Evidence ◽  
Notch Width ◽  
Femoral Notch ◽  
Notch Width Index

Background: Given the relatively high risk of contralateral anterior cruciate ligament (ACL) injury in patients with ACL reconstruction (ACLR), there is a need to understand intrinsic risk factors that may contribute to contralateral injury. Hypothesis: The ACLR group would have smaller ACL volume and a narrower femoral notch width than healthy individuals after accounting for relevant anthropometrics. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Magnetic resonance imaging data of the left knee were obtained from uninjured (N = 11) and unilateral ACL-reconstructed (N = 10) active, female, collegiate-level recreational athletes. ACL volume was obtained from T2-weighted images. Femoral notch width and notch width index were measured from T1-weighted images. Independent-samples t tests examined differences in all measures between healthy and ACLR participants. Results: The ACLR group had a smaller notch width index (0.22 ± 0.02 vs 0.25 ± 0.01; P = 0.004; effect size, 1.41) and ACL volume (25.6 ± 4.0 vs 32.6 ± 8.2 mm3/(kg·m)−1; P = 0.025; effect size, 1.08) after normalizing by body size. Conclusion: Only after normalizing for relevant anthropometrics, the contralateral ACLR limb had smaller ACL size and narrower relative femoral notch size than healthy individuals. These findings suggest that risk factor studies of ACL size and femoral notch size should account for relevant body size when determining their association with contralateral ACL injury. Clinical Relevance: The present study shows that the method of the identified intrinsic risk factors for contralateral ACL injury could be used in future clinical screening settings.

scholarly journals Increased Total Cost and Lack of Diagnostic Utility for Emergency Department Visits After ACL Injury

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110067
Author(s):  
Lambert T. Li ◽  
Carlin Chuck ◽  
Steven L. Bokshan ◽  
Brett D. Owens
Keyword(s):  
Emergency Department ◽  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Emergency Department Visits ◽  
Level Of Evidence ◽  
Total Cost ◽  
Acl Tear ◽  
Chi Square Analysis

Background: Patients are commonly evaluated at the emergency department (ED) with acute anterior cruciate ligament (ACL) tears, but providers without orthopaedics training may struggle to correctly diagnose these injuries. Hypothesis: It was hypothesized that few patients would be diagnosed with an ACL tear while in the ED and that these patients would be of lower socioeconomic status and more likely to have public insurance. Study Design: Cohort study; Level of evidence, 3. Methods: The 2017 State Ambulatory Surgery and Services Database (SASD) and State Emergency Department Database (SEDD) from the state of Florida were utilized in this study. Cases with Current Procedural Terminology code 29888 (arthroscopically aided ACL reconstruction [ACLR]) were selected from the SASD, and data from the SEDD were matched to patients who had an ED visit for a knee injury within 120 days before ACLR. Chi-square analysis was used to test for differences in patient and surgical variables between the ED visit and nonvisit patient groups. A generalized linear model was created to model the effect of ED visit on total cost for an ACL injury. Results: While controlling for differences in patient characteristics and concomitant procedure usage, a visit to the ED added $4587 in total cost ( P < .001). The ED visit cohort contained a greater proportion of patients with Medicaid (20.2% vs 9.1%), patients who were Black (18.4% vs 10.3%), and patients in the lowest income quartile (34.4% vs 25.0%) ( P < .001 for all). In the ED visit cohort, 14.4% of patients received an allograft versus 10.1% in the non-ED visit cohort ( P = .001) despite having a similar mean age. An ACL sprain was diagnosed in only 29 of the 645 (4.5%) patients who visited the ED. Conclusion: Utilizing the ED for care after an ACL injury was expensive, averaging a $4587 increase in total cost associated with ACLR. However, patients rarely left with a definitive diagnosis, with only 4.5% of patients who underwent ACLR being correctly diagnosed with an ACL tear in the ED. This additional cost was levied disproportionately on patients of low socioeconomic status and patients with Medicaid.

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

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.

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

2009 ◽  
Vol 44 (1) ◽  
pp. 101-109 ◽  
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.

Psychological Readiness to Return to Sport Is Associated With Second Anterior Cruciate Ligament Injuries

2019 ◽  
Vol 47 (4) ◽  
pp. 857-862 ◽  
Author(s):  
April L. McPherson ◽  
Julian A. Feller ◽  
Timothy E. Hewett ◽  
Kate E. Webster
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Characteristic Curve ◽  
Return To Sport ◽  
Acl Injury ◽  
Short Version ◽  
Cutoff Score ◽  
Level Of Evidence ◽  
Younger Patients ◽  
Anterior Cruciate

Background: Psychological responses after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) have been identified as predictors of return to sport but have not been investigated in relation to further injury. Purpose/Hypothesis: To determine whether psychological readiness to return to sport is associated with second ACL injury. It was hypothesized a priori that at both preoperative and 12-month postoperative time points, patients who sustained a second ACL injury would have lower psychological readiness than patients who did not have a second injury. Study Design: Cohort study; Level of evidence, 2. Methods: Patients who had a primary ACLR procedure between June 2014 and June 2016 completed the ACL–Return to Sport after Injury (ACL-RSI) (short version) scale before their ACLR and repeated the scale at 12 months after surgery to assess psychological readiness to return to sport. Patients were followed for a minimum of 2 years (range, 2-4 years) after surgery to determine further injury. The primary outcome was the relationship between ACL-RSI scores and the incidence of second ACL injury. Results: In 329 patients who returned to sport after ACLR, 52 (16%) sustained a second ACL injury. No difference in psychological readiness was observed at the preoperative time point, but patients who sustained a second injury trended toward lower psychological readiness at 12 months compared with noninjured patients (60.9 vs 67.2 points; P = .11). Younger (≤20 years) patients with injury had significantly lower psychological readiness to return to sport than young noninjured patients (60.8 vs 71.5 points; P = .02), but no difference was found in older patients (60.9 vs 64.6 points; P = .58). In younger patients, receiver operating characteristic curve analysis revealed a cutoff score of 76.7 points with 90% sensitivity to identify younger patients who sustained a second ACL injury. Conclusion: Younger patients with lower psychological readiness are at higher risk for a second ACL injury after return to sport.

Incidence of Major Tendon Ruptures and Anterior Cruciate Ligament Tears in US Army Soldiers

2007 ◽  
Vol 35 (8) ◽  
pp. 1308-1314 ◽  
Author(s):  
Daniel W. White ◽  
Joseph C. Wenke ◽  
Dan S. Mosely ◽  
Sally B. Mountcastle ◽  
Carl J. Basamania
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Tendon Rupture ◽  
Medical Center ◽  
Cruciate Ligament ◽  
Rare Event ◽  
Quadriceps Tendon ◽  
Level Of Evidence ◽  
Black Soldiers ◽  
Tendon Ruptures

Background Although a rare event, the prevalence of major tendon rupture has increased in recent decades. Identification of risk factors is important for prevention purposes. Hypothesis Race is a risk factor for major tendon ruptures. Study Design Cohort study (prevalence); Level of evidence, 2. Methods All patients admitted for surgical management of a rupture of a major tendon at Womack Army Medical Center, Fort Bragg, North Carolina, in 1995 and 1996 were identified and evaluated for risk factors. Results The authors identified 52 major tendon ruptures 29 Achilles, 12 patellar, 7 pectoralis major, and 4 quadriceps tendon ruptures. All patients were active-duty soldiers, and 1 was a female soldier. Forty-one tendon ruptures occurred among black soldiers, 8 occurred among white soldiers, and 3 occurred among Latino soldiers. The population at risk included 93 224 exposures during the 2-year period, of which 67.1% were white, 24.5% were black, and 8.4% were self-classified as other race. The rate ratio for tendon rupture, adjusted for gender and age, was 13.3 (95% confidence interval, 6.2-28.5) between blacks and whites and 2.9 (95% confidence interval, 0.8-10.9) between Latinos and whites. Conclusion The rate of major tendon rupture was 13 times greater for black men in this study population when compared with whites. Interventions among those at a higher risk for injury should be considered.

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